CAPD Flashcards
GIN Threshold
73% sensitivity
84% specificity
GIN Percent Correct Score
56% sensitivity
87% specificity
Frequency Pattern Test
80-90% sensitivity
90-100% specificity
Staggered Spondaic Word Test
No sensitivity reported
77% specificity
SCAN 3:C Filtered Word Subtest
No sensitivity and specificity reported
500-Hz MLD
- 4% sensitivity
60. 3% specificity
Why are screening tools useful for evaluating children 6-7 years old?
These tests can be used to screen children whose auditory systems have not completely developed.
If a child younger than 7 performs poorly on behavioral measures, they should be identified as a child at-risk for developing CAPD
What is temporal processing?
- Refers to the perception of temporal characteristics of a signal over time and may include tasks related to gap detection, integration, and sequencing of patterns C
- Temporal processing tasks are sensitive to lesions in the right hemisphere of the auditory cortex.
- If a verbal response is required for the test, then that test will also be sensitive to lesions in the left hemisphere of the auditory cortex.
What test will be used to assess temporal resulution?
Gaps in Noise C
- Assesses temporal resolution.
- Sensitive to cortical and brainstem lesions.
- Appropriate for young children due to low cognitive demand and auditory system maturity of the brainstem and cortex.
What test will be used to assess temporal sequencing?
Frequency Pattern Sequence Test (FPT) C
- Sensitive to cortical and corpus callosum lesions.
- Ear differences are not common.
- Appropriate for children 8 years and older
What is dichotic listening?
- Refers to an individual’s abilities to integrate or separate speech stimuli presented to each ear simultaneously
- Presents stimuli to both ears, which then travels through the ipsilateral and contralateral pathways, including the corpus callosum.
- Dichotic listening tasks are most sensitive to auditory cortex and interhemispheric lesions.
- They can also be sensitive to auditory brainstem lesions.
What test is used to assess dichotic listening?
Staggered Spondaic Word (SSW) Test
- Both a measure of dichotic listening and binaural interaction.
- Linguistically loaded.
- Sensitive to brainstem, cortical, and corpus callosum lesions.
- The test is simple enough for school-age children to understand.
What is monaural low-redundancy speech?
- Monaural low-redundancy speech tasks examine an individual’s abilities to recognize degraded speech stimuli, either filtered or temporally altered
- Evaluates the process of auditory closure
- Auditory closure is an individual’s ability to fill in missing or distorted parts of the auditory signal and comprehend the meaning of the message.
What test will be used to assess monaural low-redundancy speech?
SCAN-3:C Filtered Words Subtest C
- Presents low-pass filtered monosyllabic words from the Spache readability word list and the Kindergarten Phonetically Balanced word lists.
- The low-pass filtered speech test is sensitive to brainstem/cortical lesions.
What is binaural interaction?
- Assesses the identification of intensity or temporal differences of stimuli presented separately (diotic) to each ear
- Requires the listener to integrate the information in order to perceive the entire message.
What test will be used to assess binaural interaction?
500-Hz MLD
- One of the more sensitive tests in the binaural interaction category.
- The MLD is sensitive to low brainstem lesions.
- Can be administered to children.
- Not resistant to peripheral hearing loss.
Besides behavioral measures, what assessment should be conducted?
Electrophysiologic assessment
- If a child has abnormal performance on CAPD behavioral measures, then they should undergo objective assessment.
- Conducting an electrophysiologic assessments can objectively demonstrate neural deficits within the CANS.
- Electrophysiologic measures are also resistant to factors that affect performance on behavioral measures, including attention, fatigue, and motivation.
- These measures can also be resistant to comorbid conditions such as language disorders.
What electrophysiologic measures should be conducted?
Auditory brainstem response (ABR)
- The ABR is an early latency response.
- An abnormal ABR occurs in patients with lesions in the auditory nerve and/or caudal brainstem.
Middle latency response (MLR)
- The MLR occurs after the ABR.
- The MLR is sensitive to lesions in the thalamus and primary auditory projections.
P300
- The P300 is a late response that assesses cortical functions.
- The P300 is sensitive to lesions within the cerebrum.
What developmental conditions present similarly to CAPD?
- SLI
- Dyslexia
- ADHD
- Hearing loss
What are the overlapping symptoms between CAPD and other conditions?
- Poor attention
- High distractibility
- Reading and language difficulties
- Difficulties following instructions
What is dyxlexia?
- Dyslexia is a disability characterized by difficulty learning to read in the presence of normal intelligence
- Children with dyslexia have poor performance on certain CAPD behavioral measures, such as the Pitch Pattern Sequence Test, the Dichotic Digits, and Gap Detection
What is SLI?
- The etiology of SLI is unknown, but can be explained by the temporal auditory processing deficit theory.
- Children with SLI are unable to process rapid speech and environmental sounds due to abnormal encoding of auditory information.
- Children with SLI demonstrate abnormal temporal processing and frequency discrimination.
- Children with SLI and CAPD perform similarly on behavioral measures.
What is ADHD?
- Children with ADHD present with hyperactivity, inconsistent task performance, and academic, social, and emotional problems.
- ADHD is thought to affect executive functions, such as attention and working-memory.
- Both children with ADHD or CAPD can present as inattentive or easily distracted, require multiple repetitions of instructions, and have difficulty listening in background noise
How does hearing loss affect performance on CAPD behavioral measures?
- During CAPD assessment, it is important to determine if the abnormal performance is due to a hearing loss or deficits in central auditory processing.
- It is possible that abnormal performance may be due to changes in the CANS as a result of sensory deprivation, rather than a central auditory processing disorder.
- Peripheral hearing loss can affect performance on a number of central auditory processing tasks; however, some behavioral measures are more resistant to mild to moderate sensorineural hearing losses.
What aer other factors that affect performance?
- Performance can be influenced by various factors, including memory, attention, motivation, fatigue, and linguistic abilities.
- Children may experience auditory fatigue as a result of an arduous and extensive test session.
- This is demonstrated by declining performance on tests towards the end of the session.
- Children assessed for CAPD may have behavioral and/or cognitive problems that require medication.
- It is important that these children are properly medicated prior to and during testing.
- Not taking a medication can impact performance.
- Given that fatigue and attention can affect most children’s performance, the audiologist administering the test battery needs to be time-efficient during testing.
- The audiologist also needs to monitor each patient’s alertness, motivation, and energy level during the test session.
How can the audiologist account for the range of auditory abilities across the age range of patients?
- The majority of behavioral tests involve interhemispheric function, which matures at variable rates in young children.
- Between the ages of 6 and 12, the auditory cortex continues to develop.
- By age 11 or 12, the axons in the auditory cortex reach the same maturity level as adults
- Improvements in complex auditory processing occur due to increased communication between the auditory cortex of the right and left hemispheres
- As the auditory cortex continues to develop, waves of the P300 response appear by age 9.
- Additionally, as children develop, their speech processing and discrimination abilities in adverse listening environments improves
How can auditory ability affect performance on CAPD measures?
- It is important that the audiologist considers how auditory system development can impact performance on behavioral measures.
- Ear advantages also demonstrate possible lesions in the corpus callosum.
- For example, on the SSW, young children can demonstrate a right-ear advantage if they have an underdeveloped corpus callosum or have corpus callosum impairment
