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Year 2 Courses > CAPD Quiz 1 > Flashcards

CAPD Quiz 1 Flashcards

1
Q

sylvian fissure

A

appears to be the marker for linguistic capacity
-runs between broca’s and wernicke’s area

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2
Q

angular gyrus

A

involved in processing of auditory/visual input and language comprehension
-between the parietal, occipital and temporal lobe

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3
Q

angular gyrus integrates, processes and connects functional areas including …..

A

auditory, visual and language

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4
Q

aphasia

A

impairment of language that affects the production or comprehension of speech and the ability to read or write
-due to a brain injury (such as a stroke) but can also occur from disorders such as tumors, trauma, infections and MS

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5
Q

wernicke’s aphasia

A

comprehension of speech is impacted, motor language skills intact
-what they speak is not true speech, it is often nonsense due to lacking feedback comprehension

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6
Q

wernicke’s aphasia has damage to …

A

wenicke’s area, in the left temporal lobe
-adjacent to the primary auditory area

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6
Q

broca’s aphasia

A

most language skills are impacted, comprehension is intact
-non-fluent speech, poor repetition, few words and many pauses but aural comprehension is generally intact

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7
Q

global aphasia

A

occurs when a stroke or other condition impacts extensive parts of the front and back regions of the left hemisphere
-significant damage occurs

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7
Q

broca’s aphasia has damage to …..

A

broca’s area, in the inferior frontal gyrus of the frontal lobe
-cerebellum may be involved due to it being the internal clock

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8
Q

anomia

A

specific type of aphasia in which there is difficulty remembering the proper words to describe an attribute, action or object
-results from cortical or subcortical strokes or cerebral insults

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9
Q

executive function

A

higher level cognitive skills used to control other cognitive abilities and behaviors
-both organizational and regulation abilities

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10
Q

examples of regulation abilities

A

initiation of action, self control, emotional regulation and decision making

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11
Q

where do executive functions occur

A

frontal lobe in particular the prefrontal cortex

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12
Q

examples of organizational abilities

A

attention, planning, sequencing, problem solving, working memory and cognitive flexibility

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13
Q

what are the 3 divisions of the auditory cortex

A

primary auditory cortex/core (A1), belt (A2) and the parabelt (A3)

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14
Q

how is spatial processing mediated

A

it is mediated by two perceptual channels, each with hemifield azimuth tuning with medial borders
-processing near midline depends on the output from both
-spatial processing of sources deep in one or other auditory hemifield is dominated by one or the other channel

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15
Q

how does location of the speech and noise impact how the person perceives the signal

A

if they are in the same spatial channel it is harder, if they are in different spatial channels it is easier

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16
Q

how do efferent pathways play a role in audition

A

efferent pathways run from the cortex to the cochlea mediating auditory mechanisms
-in particular the olivocochlear bundle
-carries information from the CANS to the cochlear
-making contact with OHCs affecting their activity

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17
Q

olivocochlear bundle (OCB) in relation to audition

A

extends from SOC to fibers to cochlear hair cells
-medial OCB is believed to cause OAE suppression

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18
Q

sensitivity

A

correctly identifying those who have the disorder
- (hit / hit + miss) x 100

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19
Q

specificity

A

correctly identifying those who do not have the disease
- (correct rejection / correct rejection + false alarms) x 100

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20
Q

stimulus presented, heard it ….

A

hit

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21
Q

no stimulus, heard it ….

A

false alarm

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21
Q

stimulus presented, did not hear it …

A

miss

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21
Q

predictive value

A

the likelihood that a positive result indicates disease or that a negative result excludes disease
-positive PV (PPV) the proportion of positive tests that are true positives
-negative PV (NPV) are the proportion that are negative tests and correct rejections

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22
Q

no stimulus, did not hear it ….

A

correct rejection

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23
Q

PPV will be stronger when ……

A

the disease is more common

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24
Q

within an ROC, there is a diagonal line. what is the function of this

A

the line is the random guess or chance (50%) performance line
-below the line indicates a not very good test
-above the line indicates a better, more sensitive test

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24
Q

ROC curves

A

a measure of accuracy and meaningful interpretations of test results
-importance in finding the optimal cut off values for normal vs. abnormal test results

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25
Q

on an ROC, what is plotted on each axis

A

sensitivity is on the y axis and specificity is on the x axis

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25
Q

what are two pitch perception concepts

A

frequency discrimination and frequency selectivity

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25
Q

theories of pitch perception

A

place theory and temporal/volley theory

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25
Q

place theory

A

based around the place of maximum stimulation and tonotopic organization along the basilar membrane
-this corresponds to the maximum displacement in the traveling wave response (frequency place mapping)

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25
Q

frequency discrimination

A

ability to detect changes in frequency

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25
Q

frequency selectivity

A

ability to resolve a complex sound to its component frequencies

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25
Q

what frequencies does the place theory play a larger role with

A

high frequencies
-believed that phase locking might be necessary for the sensation of pitch

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25
Q

temporal or volley theory (role of auditory neurons)

A

based on how neurons phase lock to vibrations of the BM and therefore the pitch is assigned to a signal that is determined by the timing pattern of neural impulses evoked by a stimulus
-dependent on the timing

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26
Q

how does the temporal or volley theory work

A

with neural desynchrony, they fire in a poor pattern leading to not understanding what is being said
-when low frequencies are heard, neurons tend to fire at a particular phase of the waveforms so that the neural spikes are at or close to multiples of the period of pure tones

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27
Q

when there are broader auditory filters or a reduced frequency selectivity, what occurs

A

speech perception and music appreciation is difficult

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27
Q

what is the pitch of missing fundamental

A

even if the fundamental frequency was removed from the signal, pitch perception did not change which is due to the brain interpreting repetition patterns

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28
Q

how does the pitch of the missing fundamental occur

A

the first tone that is heard has all the frequencies and the second tone heard has the fundamental removed but maintains all the higher harmonics
-although the character of each note changes, the pitch remains the same

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29
Q

why is there variability among people with cochlear HL despite them having similar thresholds

A

all relating to individual differences in auditory filter size and neural synchrony
-well preserved synchrony is good pitch discrimination

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29
Q

how is pitch perception impacted by a cochlear HL

A

a cochlear HL is associated with reduced frequency selectivity, meaning a broader auditory filters
-individuals are getting the correct cues
-rely more on temporal information

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30
Q

how is pitch perception impacted with CI patients

A

they will often complain about not liking music as they cannot perceive pitch anymore
-due to the filters in the cochlea
-with a HL, there is a wider filter and the discrete ability to detect differences is impacted and therefore music is impacted

30
Q

with regards to temporal resolution, what are the two different gap detection thresholds

A

within channel (within their own filter/channel, detecting within the channel) and across channels (outside of the filter/channel, using additional filters)

31
Q

gap detection threshold

A

the smallest amount of silence detected between two signals
-generally is around 2 to 3 ms
-needs to be tested above threshold
-done at frequencies between 200 and 4000 Hz

31
Q

two aspects that are important when discussing amplitude modulation

A

modulation rate : how close or how far they are depending on the rate
modulation depth : how far above does it move from baseline

32
Q

temporal integration or summation

A

ability of the auditory system to add information over time
-appears to integrate a pure tone signal over a 200 to 300 ms period
-thresholds will therefore not improve if the signal duration is greater than 300 ms (it could worsen due to adaptation)

33
Q

amplitude modulation detection threshold

A

determine the smallest amount of variation needed to detect that a sound if fluctuating
-the degree of change determines modulation depth of a signal

34
Q

ability to detect modulation worsens at …..

A

low SL’s and high frequencies

34
Q

forward masking

A

signal is presented after the masker
-signal duration needs to be short and the masker duration is long
-within the 100 to 200 ms time frame, anything over this will not occur

35
Q

temporal masking

A

when the masker and test signal do not overlap in time, there is a separation between the signal and masker
-forward and backward masking

35
Q

duplex theory

A

based around the idea of containing two sound cues used for localization
-involves interaural temporal or level differences

36
Q

backward masking

A

signal is presented before the masker
-signal duration is short and masker is long
-within the 25 to 50 ms time frame

37
Q

interaural temporal or phase differences (ITD or IPD)

A

provides localization information for low frequency stimuli
-comparing phase differences arriving to each ear
-the wavelength of sound waves is smaller than the diameter of the head

37
Q

interaural level difference (ILD)

A

provides localization information for high frequency stimuli
-comparing intensity difference between the signals between each ear
-higher frequencies have shorter wavelengths which are around the side of the head, which produces a sound shadow

38
Q

minimum audible angle (MAA)

A

detection of small shifts in position of sound source between reference and comparison signals
-basically, how different a signal has to be positional wise to detect a difference

38
Q

MAA with ITD cues

A

smallest for sounds coming from the front
-around 3 degrees for frequencies up to 900 Hz

39
Q

MAA with ILD cues

A

smallest for sounds coming from the front
-changes can be detected when degrees are greater than zero

40
Q

two binaural hearing processes

A

fusion (sensation of hearing a fused signal at midline) and beats (when two signals produce a beat)

40
Q

in order to hear beats, the signals has to have ….

A

two frequencies that are very close to each other

41
Q

what are the beats

A

waxing and waning of a signal
-the difference between the two frequencies are the amount of beats that will be heard!!
-so subtract the two from each other

42
Q

beats will not be heard if …

A

signals are the same frequency and if the different is greater than 50 to 100 Hz

43
Q

perceptual coherence

A

if signals have similar acoustic properties those signals can then be equaled out
-common properties can include fundamental frequency and voice onset time

44
Q

precedence effect (law of the first waveform)

A

describes and illusion produced when two similar sounds are delivered in quick succession from sound sources at different locations but only a single sound is perceived
-whichever wave hits the ears first is what is heard
-the binaural auditory system tends to suppress the later arriving sounds and emphasizes the first wave

45
Q

modulation detection interference (MDI)

A

amount of masking or interference caused by the modulating masker
-a modulated signal can cross filters whereas a unmodulated signal can’t cross filters which is why the modulated signal is therefore able to mask

46
Q

when testing speech, what does MDI have to do with it

A

shows why we need to use a modulated signal as a masker!

47
Q

when the masker and signal frequency are different, the threshold for modulation detection for the signal ……

A

decreases (gets better)

47
Q

comodulation masking

A

the detection of a tone centered in a modulated band of noise is improved with the addition of another band of modulated noise
-threshold gets better when the two noises (maskers) are similar and the signal is the only thing that is different

48
Q

when the masker and signal frequency are similar, threshold for detection for the amplitude modulated signal …….

A

increases (gets worse)

49
Q

what are some factors that may aid listening in regards to the cocktail party effect

A

spatial separation, different pitches of different speakers, different fundamental frequencies of speakers, different accents and different speeds of sound reaching the ears

49
Q

cocktail part effect (spatial separation)

A

ability to focus the listening attention on a single talker among various voices and background noise
-the brain is able to detect the important signal vs. the not important signal/background noise

50
Q

what are normal auditory processing functions

A

sensation, localization, auditory resolution/discrimination, auditory attention, auditory figure ground, auditory closure, auditory analysis, auditory synthesis, auditory association, auditory memory, temporal effects, temporal masking and binaural hearing

50
Q

localization

A

ability to determine the location of the acoustic signal relative to the listeners position in space

51
Q

sensation

A

ability to identify the presence of a sound

52
Q

auditory attention

A

ability to attend to relevant acoustic signals, such as speech and sustain that attention for an age appropriate amount of time
-if impacted, they cannot attend to the important things

52
Q

auditory resolution or discrimination

A

ability to discriminate between sounds that differ in frequency, duration and intensity
-problems with this can result in academic difficulty, reading, spelling and writing skills

53
Q

auditory figure ground

A

ability to identify the primary linguistic or non-linguistic sound source from background noise

54
Q

auditory synthesis

A

ability to synthesize phonemes into words
-critical to the reading process

54
Q

auditory analysis

A

important for distinguishing verb tenses and other morphological markers that may be acoustically distorted or masked by background noise

54
Q

auditory closure

A

ability to understand the whole word or message when a part is missing

55
Q

auditory memory

A

recall of an acoustic signal after it has been labeled and stores
-sequential memory : ability to recall the order of acoustic stimuli
-short term memory : ability to retain and recall auditory information as it was presented

55
Q

auditory association

A

ability to attach meaning to the sound
-important for developing auditory memory

55
Q

temporal effects

A

talking about aspects that occur within the nerve
-temporal integration and temporal resolution

56
Q

temporal resolution

A

detection of small timing differences when processing speech
-common method is gap detection threshold

56
Q

temporal integration

A

ability to integrate inputs over time, enhancing the detection and discrimination of a sound
-pure tone duration of 200 to 300 ms
-increase in duration results in 10 dB improvement in threshold

57
Q

temporal masking

A

occurs when the masker and test signal do not overlap in time

58
Q

central auditory processing disorder (C)APD

A

a complex, heterogenous, bottom up perceptual disorder affecting the auditory system
-a sensory processing deficit that impacts listening, spoken language, comprehension and learning

58
Q

binaural hearing

A

two ears are better than one

59
Q

two hypotheses behind (C)APD

A

general auditory hypothesis (auditory modality deficit) or language specific hypothesis (language modality deficit)

60
Q

academic profile of (C)APD

A

typically almost all children referred for these evaluation are struggling academically
-child not working up to potential
-weakness in spelling, reading and/or writing
-strong math skills
-difficulty following instructions/multi step instructions
-failed or failing a grade
-significant scatter in ability
-better performance on non-auditory tasks
-verbal IQ score lower than performance IQ

61
Q

non academic profile of (C)APD

A

all can be exaggerated in noise or with degraded acoustic stimuli
-may appear hearing impaired but hearing sensitivity is normal
-history of chronic or recurrent OME
-repeatedly saying huh or what and asking people to repeat
-poor sound localization
-may have poor music skills and difficulty learning rhymes/songs
-may have problems with fine
-gross motor skill or may inhibit behavioral problems

62
Q

what are the diagnostic criteria for (C)APD

A

age, cognitive abilities, speech and language abilities, auditory function and exclusionary diagnosis

63
Q

(C)APD diagnostic criteria : age

A

children should be at least 7 years old
-we cannot test diagnostically under the age of 7

64
Q

why is there an age requirement for diagnostic testing

A

the tests require a certain level of cognition and language skills to complete

65
Q

(C)APD diagnostic criteria : cognitive abilities

A

a child with reduced intellectual skills would demonstrate reduced auditory ability therefore, intelligence should not be a factor when assessing a child

66
Q

(C)APD diagnostic criteria : speech and language

A

minimum language age should be 6 years or older or within a year of the chronological age of language development
-English should be primary language
-children should have intelligible speech so it can be interpreted

67
Q

(C)APD diagnostic criteria : auditory function

A

hearing should be WNL and there should be no ME dysfunction

68
Q

(C)APD diagnostic criteria : exclusionary diagnosis

A

the following need to be ruled out prior :
-ADHD
-language and phonological processing problems
-learning delay/disability
-cognitive impairment
-autism and autism spectrum disorder

69
Q

what are the subtypes of (C)APD

A

lexical decoding deficits, tolerance fading memory (TFM), organizational deficits or output organization deficit, integration deficits

70
Q

lexical decoding deficits

A

characterized by difficulties in processing the words of a language, both verbal and written
-most common type
-mistakenly diagnosed as ADHD
-cortical area is the let posterior temporal lobe

71
Q

tolerance fading memory (TFM)

A

characterized by difficulty listening in noise and recalling information presented earlier
-includes weak expressive language and poor handwriting
-cortical area is the frontal and anterior temporal lobe

72
Q

organizational deficits or output organizational deficit

A

diagnosed when significant corrupted auditory sequencing or planning is noted
-difficulty with sequential information
-cortical area is the pre and post central gyri

73
Q

integration deficits

A

decreased ability to integrate acoustic and linguistic information across different processing modalities
-long delays in response to auditory stimuli, writing and use of language
-cortical area is the corpus callosum

74
Q

common comorbidities with (C)APD

A

ADHD, phonological processing and language deficits, reading/spelling problems and learning delays

75
Q

lax criterion

A

if they fail only one test, they have it
-yields a better sensitivity but poor specificity
-as the size of the battery increases, greater probability that a patient will fail any single test

76
Q

strict criterion

A

all tests need to be failed to have the diagnosis
-yields a better specificity but poor sensitivity
-as size of battery increases, less probability that a patient will fail all of the tests

77
Q

intermediate criterion

A

abnormal on at least 2 tests or abnormal on at least 1 test
-based on standard deviations of tests
-the most reliable

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