Speech Perception Training Flashcards
What are the factors contributing to difficulty identifying a target speaker in multi-talker babble?
Prolonged neural refractory times
Loss of myelin integrity
Decreased brain connectivity
Increased variability in neural firing
Do older adults require a higher SNR?
Yes
Even in the absence of hearing loss older adults require an extra 3-5 dB SNR
Partly due to auditory mismatch resulting from age-related hearing loss)
Also relates to reductions in cognitive processing abilities (higher SNR reduces the cognitive load - +10 to +15 SNR)
What is the OPERA hypothesis?
Proposes that musical experience facilitates speech encoding when 5 conditions are met:
The neural networks for music and speech must overlap anatomically (Overlap)
The music activities must entail more precise acoustic processing than speech (Precision)
The music must bring about strong positive emotion (Emotion)
The signal is repeat frequently (Repetition)
Listening requires focused attention (Attention)
*Speech encoding remains intact with aging
Which populations have advanced brainstem encoding skills?
Individuals with musical training (overlaps in anatomical brain networks that process speech and music)
Tonal language
Bilingual language speakers (greater brainstem encoding for fundamental frequency for stimuli presented both in quiet and noise)
What do older normal hearing musicians have?
Faster brainstem timing
Greater representation of the harmonics of a speech syllable
Superior cognitive skills which offset decline in working memory
Does making music affect the brain’s ability to extract critical information?
Yes
Music helps language development
Musical experience and/or therapy helps hard of hearing person’s ability to process auditory signals
Inclusion of case history questions:
Are they a musician/ do they play an instrument?
Do they listen critically to music?
Does Dr. Kraus’ research suggest that perceptual training improves neural plasticity in adults?
Yes
In her study, the subjects were 60 to 85 years old
Outcomes: faster processing speed and improved memory
Control group showed no changes
Does the brain reorganize itself when it is deprived from signal and then when it starts up again?
Yes
Even shown in mild hearing losses
Found recovery of cross-modal reorganization of the auditory cortex by vision (when they were fit with bilateral hearing aids)
Promotes the use of hearing aids (requires them to be well-fit)
Does this research suggest that perceptual training improves function and should be included in our patient’s plan of care?
Yes
Speech perception training (synthetic training, analytic training, transfer appropriate processing theory (TAP), meaning-based orientation training, and active filter hypothesis training)
Brain fitness program
What is speech perception training?
A structured approach to improving auditory processing skills
Focuses on enhancing the ability to perceive and understand speech, especially in challenging listening environments
Why is speech perception training important?
Can improve speech understanding, especially for individuals with hearing loss
Can enhance listening skills in noisy environments
Can improve auditory attention and memory
What are the core components of speech perception training?
Auditory discrimination (training the ability to distinguish between similar sounds; example: minimal pair drills)
Auditory closure (training the ability to fill in missing speech sounds; example: listening to degraded speech)
Auditory memory (training the ability to retain and recall auditory information; examples: digit span tasks, sentence repetition tasks)
Auditory attention (training the ability to focus on relevant auditory information and ignore background noise; examples: dichotic listening, listening in noise)
What is synthetic training?
Type of speech perception training
Uses top-down processing to take in and analyze information, without attempting to identify every word or sound
What are synthetic training tasks?
Auditory closure training
Speechreading training
Communication strategies
Effective use of context during communication
What is analytic training?
Type of speech perception training
Uses bottom-up processing to improve recognition of individual phonemic speech elements
Focusing in on the ability to hear/identify every individual sound
What are analytic training tasks?
Sound identification drills, lipreading drills etc. to improve detection, discrimination, & localization skills (these drills also improve the ability to track the desired signal in the presence of noise)
Temporal integration tasks: to gather meaning from sequential auditory events (t and ap; combining to tap)
Temporal ordering tasks: to improve the ability to maintain proper sequence of acoustic stimuli
Binaural interaction tasks: to use dichotic listening to effectively focus on primary signal and suppress noise
What is transfer appropriate processing (TAP) training theory?
Training tasks that match the PHL’s desired outcome are more effective
Suggests PHL will improve understanding of a CP if that person’s voice is the stimuli
Suggests PHLs who want to improve general understanding of conversations are best served by training on words appearing regularly in conversations
*Not a ton of research on this, not sure if this is beneficial
What is meaning-based orientation training?
Use of training materials stimuli that activate language processing centers of the auditory cortex just like in real world communication (words, sentences, etc.)
Nonsense syllables do not active these centers
Use real world based training materials rather than nonsense syllables (more meaningful)
What is the active filter hypothesis training?
Recognizes emotional factors block effectiveness of listening skills
Reduced anxiety during auditory training by varying conditions maintaining an 80% success rate
Sometimes its really hard sometimes its really easy
Does each type of perceptual training support the other?
Yes
Training analytic perception improves cognition
Training cognition influences synthetic perception
Training synthetic perception increases focus on analytic perception
What are some clinical considerations for speech perception training?
Individualized treatment plan (to meet the specific needs of each patient)
Progress monitoring (regularly assess patient progress and adjust treatment as needed)
Home practice (encourage patients to practice at home to reinforce learning)
What is the auditory training exercise progression?
Phoneme-Level Exercises (minimal pair drills, sound discrimination tasks)
Word-Level Exercises (word recognition in noise, word identification in lists
Sentence-Level Exercises (sentence repetition tasks, sentence comprehension tasks)
Discourse-Level Exercises (listening to stories or lectures, following complex instructions) - when top-down processing kicks in
Who should we refer to to perform AR?
SLP specializing in adult AR
Auditory-verbal therapist (qualified teachers of the deaf that have certification in AVT - more focused on bottom-up processing)
Computer-based speech perception training (not a lot have solid research behind them)
What are 5 essential attributes for effective speech perception training?
It provides timely feedback after each response
Availability of a large set of training stimuli by multiple speakers (don’t want the person training with the same words and the same speakers)
Options for training on specific phonemes that are difficult for an individual (input audiogram into software)
Inclusion of both analytic and synthetic activities
A curriculum that tracks performance so that listeners continue to complete the training program
What are the advantages for computer based training options?
Flexibility, individualized practice, automatically increases/decreases effort, immediate feedback
Web-based programs will have a larger range of stimuli available than the stimuli available in mobile apps
*a moving target because programs are always popping up and going away
What are some advantages to mobile app options?
Portability & convenience for home practice
The research on mobile app programs is less extensive than it is for computerized programs so proceed with caution when recommending until researched evidence is available (good starting point though)
Cost is low or free
Research showed that phoneme discrimination training improves speech perception for PHLs who aren’t wearing HAs
What are some examples of mobile apps?
Angel sound mobile app
Starkey hear coach (??)
Hearoes
Cochlear Copilot
LACE AI
EarGym (free trail)
Examples of informal training programs?
Cochlear americas
Advanced bionics listening room
MedEl Adult Rehab kits
BITS - audiobooks that allow you to change playback speed
Listenwise - similar to BITS
TEDTalks and YouTube videos (change presentation speech and enable CC) - talk at a slower pace and articulate a little more
What are informal training programs?
Done casually, whenever the patient wants
Don’t have to sit down and do it daily
Can implement in daily life
What is the BrainSavers program?
3 times a week hour-long classes
Exercises for healthy brain aging and memory retention
Promotes movement
Formal and informal brain exercises
Brain-healthy nutritional advice and information regarding sleep
*Look for these kinds of services for our patients - important for overall cognitive health
