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AUDE 6240 (CAPD) > Lectures 6 & 7: An Overview of CAPD & Professional Guidelines > Flashcards

Lectures 6 & 7: An Overview of CAPD & Professional Guidelines Flashcards

1
Q

what is CAPD

A

Complex & heterogeneous disorder. It is a sensory processing deficit that commonly impacts listening, spoken language, comprehension, and learning. When auditory skills are weak, children may experience auditory overload. CAPD is an input disorder that impedes selective and divided auditory attention. Most Children with auditory processing problems have normal intelligence and normal hearing sensitivity.

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2
Q

ASHA 1996 Defined auditory processing in terms of performance on a specific group of auditory tasks including

A

Perception of sound (first step)
Clarification of sound
Localization and lateraliztation of sound
Attending to sound
Analyzing, storing, retrieving information (memory)
Integration of message (what is the message, any visuals associated with it)
Auditory performance with competing and degraded acoustic signals

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3
Q

asha 1996 processes of temporal features of sound include

A

Temporal integration or summation (combing or adding sounds)
Temporal resolution or discrimination (GDT - how big does the gap have to be to recognize there are 2 signals and not one)
Large gap = poorer GD
Smaller gap = better GD
Temporal ordering or sequencing (like with phone numbers, addresses, passwords etc.)
Temporal masking (forward and backward)

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4
Q

what was ASHA’s technical report 2005

A

CAPD refers to the efficiency and effectiveness in which the CANS utilizes auditory information
how efficiently do you proess sounds you are getting from the periphery

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5
Q

Certain auditory skills develop in a sequence but they are also interconnected and contribute to effective auditory processing as a whole based on

A

Depends on neuromaturation (auditory skills improve as a child’s brain matures and impacts how they can process sounds)
Children need a 10-15 dB SNR w/ typical hearing
Children with HL needs 20-25dB SNR

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6
Q

what is sensation

A

ability to identify the presence of sound
Have to realize there is sound in the environment before you can do anything with it

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7
Q

localization

A

where the sound is coming from

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8
Q

Auditory resolution/discrimination

A

Ability to discriminate between sounds that differ in frequency, duration, and intensity

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9
Q

Ability to discriminate between sounds that differ in frequency, duration, and intensity

A

auditory resolution/discrimination

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10
Q

problems with auditory resolution/discrimination

A

Problems with auditory discrimination can result in academic difficulty such as following directions, reading, spelling, and writing skills

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11
Q

ability to attend to relevant acoustic signals, such as speech and sustain that attention for an age-appropriate amount of time

A

auditory attention

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12
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

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13
Q

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

A

auditory figure ground

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14
Q

auditory figure ground

A

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

For example, in a classroom, the teacher’s voice is the primary signal other sounds/noises in the room are the competing noise

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15
Q

Ability to understand whole word or message when part is missing
Helps to fill in the blanks and understand the messages
Easier for adults with rich language base/experience than children who are building language skills

A

auditory closure

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16
Q

auditory closure

A

Ability to understand whole word or message when part is missing
Helps to fill in the blanks and understand the messages
Easier for adults with rich language base/experience than children who are building language skills

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17
Q

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

A

auditory analysis

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18
Q

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

A

auditory analysis

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19
Q

smallest unit of speech sound used to form meaningful contrasts between utterances

A

phoneme

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20
Q

smallest unit of meaning in a language; doesn’t have to be a word

A

Morpheme:

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21
Q

fxns as the foundation of language

A

morphem

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22
Q

Ability to blend phonemes into words
Critical for reading

A

auditory synthesis

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23
Q

auditory synthesis

A

Ability to blend phonemes into words
Critical for reading

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24
Q

Ability to attach meaning to sound
Fundamental for developing auditory memory

A

auditory association

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25
Q

auditory association

A

Ability to attach meaning to sound
Fundamental for developing auditory memory

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26
Q

Recall of an acoustic signal after it has been labeled and stored
Requires remembering and recalling various acoustic stimuli of different lengths & numbers
Overall memory issues can affect this

A

auditory memory

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27
Q

auditory memory

A

Recall of an acoustic signal after it has been labeled and stored
Requires remembering and recalling various acoustic stimuli of different lengths & numbers
Overall memory issues can affect this

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28
Q

auditory sequential memory

A

ability to recall order of a series of acoustic stimuli

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29
Q

ability to recall order of a series of acoustic stimuli

A

auditory sequential memory

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30
Q

ability to retain and recall auditory information as it is immediately presented

A

auditory short term memory

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31
Q

auditory short term memory

A

ability to retain and recall auditory information as it is immediately presented

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32
Q

temporal integration

A

ability of the auditory system, specifically the auditory nerve and CANS, to integrate inputs over time, which in a variety of real-world circumstances, enhances the detection and/or discrimination of a sound

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33
Q

ability of the auditory system, specifically the auditory nerve and CANS, to integrate inputs over time, which in a variety of real-world circumstances, enhances the detection and/or discrimination of a sound

A

temporal integration

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34
Q

Lowest absolute threshold

A

200-300ms

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35
Q

Tenfold increase in duration

A

10dB improvement in threshold

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36
Q

Tonal durations >300ms doesn’t improve threshold due to

A

adaptation

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37
Q

detection of small timing differences when processing speech

A

temporal resolution

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38
Q

temporal resolution

A

detection of small timing differences when processing speech

39
Q

smallest amunt of silence between two signals detected by listener

A

gdt

40
Q

GDT

A

smallest amunt of silence between two signals detected by listener

41
Q

inability to hear subtle acoustic changes that can impact speech perception

A

poor GD

42
Q

what is temporal masking

A

Delay between masker and signal
Done using louder, longer vowel sounds that can swamp softer, shorter consonant sounds
Forward (signal follows masker; masker first) & backward (signal precede masker; masker second)

43
Q

(signal follows masker; masker first

A

forward masking

44
Q

signal precede masker; masker second)

A

backward masking

45
Q

why do we need two ears

A

Two ears are better than one
Able to detect frequency and intensity differences better
Threshold for spondees and pure tones are better by around 3dB due to binaural summation
Speech intelligibility is better especially in noise (precedence effect, MLD, & perceptual coherence)

46
Q

Auditory overload is experienced when

A

auditory skills are weak
Too much auditory stimuli causes this

47
Q

facotrs that contribute to overload

A

Fast speaking rate
Increased phonetic complexity (context, syntax, etc.)
Increased acoustic/phonetic similarity
Rhyming words (might not enjoy nursery rhymes)
Reduced context
Linguistic, visual, and/or situational context are reduced
Poor listening conditions
Noisy backgrounds, increased distance from speaker, reverberation
Temporal distortions
Demand for verbatim retention or recall
give someone 3 words and after a period of time they have to repeat them back in the right order

48
Q

CAPD tests are directed to assess

A

normal auditory processing function and assess the system when in auditory overload

49
Q

what are the two opposing views to capd

A

general auditory hypothesis
language-specific hypothesis

50
Q

General auditory hypothesis

A

Deficits in higher order auditory processing of varying acoustic signals; PRIMARILY auditory modality deficit

51
Q

language specific hypothesis

A

Processing deficit is phonetic/language-based, not specifically auditory in nature

52
Q

categories of APD

A

developmental
acquired
secondary

53
Q

Cases presenting in childhood with normal hearing (i.e., normal audiometry) and no other known etiology or potential risk factors
Some individuals may retain APD into adulthood

A

developmental apd

54
Q

Cases associated with a known post-natal event (e.g., neurological trauma or infection) that could plausibly explain the APD

A

acquired apd

55
Q

Cases where APD occurs in the presence, or as a result, of peripheral hearing impairment (e.g., presbycusis or congenital SNHL)
This includes transient hearing impairment after its resolution (e.g., glue ear or surgically corrected otosclerosis)

A

secondary apd

56
Q

nonacademic profile

A

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 and songs (poor phonemic awareness/processing?)
May have problems with fine and gross motors skill
May exhibit behavioral problems

57
Q

how can any of the nonacademic profiles be exaggerated

A

can be exaggerated in noise and/or with degraded acoustic stimuli

58
Q

academic profile

A

Almost all kids referred for CAPD evals are struggling academically
Child not working up to his/her potential
Doing poorly in schoolwork and/or not testing well
Weakness in spelling, reading, and/or writing
Strong math skills (except when reading is involved)
Difficulty following instruction/multistep instructions
Failed or failing a grade
Significant scatter in ability, intelligence, or performance on achievement, psychological, and language tests often with weakness in auditory domains
Better performance on non-auditory tasks
Verbal IQ score lower than performance IQ

59
Q

academic struggles

A

Child receives Cs (if IQ > 95) or Ds and Fs (if IQ > 80)
Does not meet basic curriculum requirements with an IQ > 80 to 85
First or second grader reading well but no comprehension of the material
Works long hours but only gets b or cs
Demonstrates excessive frustration with homework

60
Q

Average IQ

A

85-115

61
Q

what is the SD of IQ

A

15

62
Q

CAPD diagnostic criteria for cognition

A

Cognitive abilities are assessed
Intellegicne shouldn’t be a facoor because a child with reduced intellectual abilities also demonstrates reduced auditory processing skills

63
Q

CAPD diagnostic criteria for S/L

A

Minimum language age should be >/= 6yrs or within a year of chronological age of language development
Variability of auditory skill maturity in children < 6 years of age is too diverse, which makes reliable testing and, therefore, diagnosis of (C)APD difficult before age 7

English as a primary language
A diverse language background may affect test interpretation and results

Intelligible speech
Most tests need a verbal response
You have to understand what they are saying in order to reliably test and interpret

64
Q

hearing sensitivity criteria for CAPD testing

A

NORMAL in both ears

Significant ME dysfunction (effusion or infection)
Can test after they recover
Affects results

65
Q

Rule out other disabilities before testing for CAPD

A

true

66
Q

The following conditions should be identified
before capd testingg

A

ADHD or executive function deficits
Language and phonological processing problems
Learning delay/disability
Cognitive impairment
Autism and autism spectrum disorders

67
Q

(C)APD should be an exclusionary diagnosis

A

tru

68
Q

subtypes of CAPD

A

Lexical Decoding Deficits (most common type)

Tolerance-Fading Memory (TFM) (second most common)

Organizational Deficits or Output-Organization Deficit

Integration Deficits

69
Q

Lexical Decoding Deficits (most common type)

A

Issues processing words verbally and written
Difficulty manipulating sound, difficulty decoding accuracy, speed or both
Cannot decode phonemes
Differential diagnosis = ADHD
Site of lesion - left posterior temporal lobe

70
Q

Tolerance-Fading Memory (TFM) (second most common)

A

Issues hearing in noise, information fades quickly from short term memory
Weak expressive language and poor handwriting
Weak expressive language and poor handwriting
Comorbidity with CAPD & ADHD (existing together)
Site of lesion: frontal and anterior temporal lobes

71
Q

Organizational Deficits or Output-Organization Deficit

A

Issues with anything sequential or planning (numbers)
Disorganized at home or school (messy desk, messy room, etc.)
will be seen with one of the other subtypes and not on its own
Site of lesion - anterior temporal lobe

72
Q

Integration Deficits

A

Difficulty integrating acoustic and visual information
Long delays in response to auditory stimuli, writing and use of language
LE deficits in dichotic tests with language based responses
REA larger than normal past 11-12 with verbal tasks

Acoustic and visual deficits
Processing delays
Site of lesion: integration deficits at the CC

73
Q

REA

A
74
Q

first cross-over in the auditory system is at the

A

SOC

75
Q

right ear crossed pathway has direct input to the left hemisphere, which is predominant for language

A

true
REA

76
Q

Information from the left contralateral pathway (already crossed to the right side) has to cross over again through the corpus callosum to get to the left hemisphere for language processing

A

true

77
Q

The REA is normal in children, typically up to ~ years, due to neuromaturation effects

A

11 to 12

78
Q

ome evidence to suggest that males have a smaller/not as robust corpus callosum

A

true

79
Q

According to some studies, that may be the reason why males may a higher ratio than females for developmental disorders such as

A

Language problems
Dyslexia
(C)APD
Learning delays
ADHD

80
Q

Genetic predisposition

A

multifactorial

81
Q

incidence

A

new cases

82
Q

prevalence

A

existing cases in a time period or popultation

83
Q

influence of environment and genetics
more than one gene involved

A

multifactorial

84
Q

C)APD is a

A

neural processing deficit of auditory stimuli

85
Q

exact etiology of (C)APD is known

A

false
unk own

86
Q

Comorbidity is common with

A

ADHD
Phonological processing and language deficits
Reading and spelling problems
Learning delays

87
Q

(C)APD is, however, not the result of dysfunction in other modalities

A

true

88
Q

Some professionals do not recognize (C)APD as a distinct clinical entity unique to the auditory system

A

true

89
Q

Developmental (C)APD is controversial

A

true

90
Q

Lax criterion will yield

A

better sensitivity but poorer specificity

91
Q

Strict criterion will yield

A

better specificity but poorer sensitivity

92
Q

lax criteria

A

As size of the test battery increases, greater probability that a patient will fail any single test
It improves sensitivity but can undermine specificity as normal patients have an increased chance of being incorrectly identified
for ex: PT is more likely to fail one test when a battery has 10 tests as compared to when it has 2-4 tests

93
Q

intermediate criteria

A

Most reliable criteria
Abnormal performance on at least 2 tests (> 2 SD below mean)
Abnormal performance on at least 1 test (> 3 SD below mean)

94
Q

strict criteria

A

As size of the test battery increases, less probability that a patient will fail all tests
Beneficial for detecting normal function and improves specificity but can undermine sensitivity as patients with abnormal function will be less likely to fail the entire battery when more tests are included
For example, a patient is more likely to fail all tests when a battery has 2 to 3 tests as compared to when it has 10 tests

AUDE 6240 (CAPD) (5 decks)

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