The Debate and Differential Diagnosis Flashcards

Question

Is a greater comorbidity between ADHD and CAPD suspected?

Answer 1

Yes The question is whether (C)APD causes some attention deficits or whether a more global ADHD negatively impacts auditory processing (C)APD is considered a condition of bottom-up primarily auditory perceptual deficiencies ADHD is considered a top-down global attention/executive function disorder

Answer 2

Information processing that is guided by higher level cognitive processes that draw on experiences and expectations to construct perceptions Top-down processing occurs any time a higher-level concept influences interpretation of lower-level sensory data Cues are based on previous experience or knowledge Example: light bulb over cartoon means idea, don't need to be told what that means

Answer 3

A form of information processing that is guided by input Perception is data driven, therefore, most sensory information such as sound is an example of bottom-up processing Senses allow us to interpret the scene around us But how a person’s expectations, knowledge, and experience will shape that scene is the influence of top-down processing Example: 15 people in a room hear the same song but there may be different emotions that song will evoke in each person based on their life experiences

Answer 4

Yes Both are essential for optimal speech processing But CAPD and ADHD are distinct

Answer 5

ADHD is associated with more global disruption of sensory information whereas (C)APD is associated with disruption of processing of auditory information only

Answer 6

Test for both For e.g., the Digit Span test on the Weschler Intelligence Scale (WISC) both in the auditory and visual modality

Answer 7

It is a common neurobehavioral childhood disorder that primarily affects children and often continues into adulthood Prevalence: about 5% in children and about 2.5% in adults (a lot of adults with ADHD develop coping mechanisms, so they no longer think the diagnosis is necessary) More frequent in males (2:1 ratio) Females more likely to present primarily with inattentive features

Answer 8

Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development

Answer 9

Present before the age of 12 (requires clinical presentation during childhood) Impairment observable in at least two settings (home and school, home and work, etc.) Clear evidence of interference with developmentally appropriate social, academic, and/or occupational function Observed independently of ASD, schizophrenia, or other intellectual disorders

Answer 10

Either inattention or hyperactivity-impulsivity

Answer 11

If six (or more) symptoms of inattention have persisted for at least six months to a degree that is inconsistent with developmental level and negatively and directly impacts social and academic/occupational activities Example of inattention symptoms: Often fails to give attention to details/makes careless mistakes Often has difficulty sustaining attention in tasks or play activities (e.g., difficulty remaining focused during lectures, or lengthy reading) Often does not seem to listen when spoken to directly Often does not follow through on instructions/fails to finish schoolwork, chores Often avoids/dislikes tasks requiring sustained mental effort (schoolwork/homework) Often easily distracted by extraneous stimuli Often has difficulty organizing tasks and activities

Answer 12

If six (or more) symptoms of hyperactivity-impulsivity have persisted for at least six months to a degree that is inconsistent with developmental level and negatively and directly impacts social and academic/occupational activities Example of symptoms: Often fidgets with or taps hands or feet or squirms in seat Often leaves seat in classroom when remaining seated is expected Often runs about or climbs in situations where it is inappropriate Often unable to play or engage quietly in leisure activities Often talks excessively Often blurts out answers before questions have been completed Often has difficulty awaiting turn Often interrupts/intrudes on others (e.g., during conversations)

Answer 13

Yes If both criterion A1 (inattention) and A2 (hyperactivity-impulsivity) are met for the past six months

Answer 14

If criterion A1 (inattention) is met but criterion A2 (hyperactivity-impulsivity) is not met for the past six months

Answer 15

If criterion A2 (hyperactivity-impulsivity) is met but criterion A1 (inattention) is not met for the past six months

Answer 16

Low birth weight (2 to 3 fold risk) History of child abuse/neglect, multiple foster home placements Neurotoxin exposure (lead, infections, in-vitro alcohol exposure) Genetic and physiologic (increased risk if first degree biological relatives have it, visual and hearing impairment, and epilepsy) *Exact causes are not understood, research suggests a combination of genetic and environmental factors

Answer 17

Medication (stimulants and non-stimulants can help improve focus and reduce hyperactivity) Therapy (coping skills) Educational interventions (accommodations and modification in school) *Could be one or a combination

Answer 18

The ability to identify sound units that make up syllables and words

Answer 19

Phonemic awareness/processing Begins to transition from primarily acoustic to linguistic Happens in the temporal lobe When the auditory processing transitions into linguistic interpretation, the SLPs assess for language deficits

Answer 20

Yes They believe that a diagnosis of (C)APD would not contribute anything to the child’s functioning beyond showing that the child is experiencing linguistically based deficits, which bear further language investigation According to them, there is not enough empirical data to support that (C)APD is a disorder primarily auditory in nature

Answer 21

Previously known as specific language impairment (SLI) or developmental dysphasia A disorder that delays the mastery of language skills in children who have no hearing loss or other developmental delays One of the most common childhood learning disabilities (affecting 7 to 8% of children in kindergarten) Persists into adulthood Affects reading and learning Early signs often present in children as young as 3 years old

Answer 22

Yes ~ 50 to 70 percent of children have at least one other family member with the disorder A recent study identified a gene mutation on chromosome 6 called the KIAA0319 gene that plays a key role in DLD This mutation also plays a role in other learning disabilities (dyslexia, autism, speech sound disorders)

Answer 23

Yes but they may not be fully present until demands increase beyond the individual's capabilities for these skills as seen during high school and college Times tests, writing complex lengthy reports, heavy academic load

Answer 24

They found no difference found between performance of children with DLD/SLI and (C)APD on any measure But both groups consistently and significantly underperformed compared to the same-aged typically developing children Speech intelligibility in both noise and quiet was unimpaired for both groups Conclusion: The children were diagnosed based on their referral route vs. actual differences (audiologist, psychologist, or SLP)

Answer 25

A learning disorder that primarily affects reading and writing skills They have been suggested to experience deficits in both categorical perception (identifying word boundaries) and speech identification in noise

Answer 26

Inconsistent with the notion that children with dyslexia suffer from a low-level temporal processing deficit but, rather suggested a role of non-sensory (e.g., attentional) factors in the children’s speech perception abilities Analyzing individual profiles suggested a lack of consistently poor individual performance in speech perception among the dyslexia group, with only a minority of children being impaired in both SIN perception and CP tasks

Answer 27

Not as much as native English speakers Behavioral tests are standardized for native English speakers Second-language learners lack necessary language experience and vocabulary, resulting in poorer performance on language-based tests Using non-language-based (C)APD tests may alleviate this problem

Answer 28

Reaches adult like until >14 years old For combined noise and reverberation conditions, performance does not reach adult-like levels until later teens Even in quiet control conditions, compared to adults, children score poorly at all intensity levels

Answer 29

Yes Tests were also very variable in younger children Typically developing children don't have very good auditory skills to begin with According to the researchers, it was unclear how these tests related to everyday listening skills (because they weren't having issues in everyday life)

Answer 30

A metacognitive component that controls processes ensuring behavior that is adaptive and goal-oriented, including listening Coordinates knowledge (cognition) and metacognitive knowledge (awareness and understanding of one's own thought processes) Needed for task analysis, planning, reflective decision-making, paying attention, learning and problem solving, self-regulation of emotions and behavior (pragmatics)

Answer 31

Yes Unlike ADHD, a causal role of executive dysfunction for (C)APD has not been fully examined But a key component of executive function, working memory deficits, have been reported in a subset of children with (C)APD Working memory supports auditory processing including localization, speech recognition in noise, pattern processing, and dichotic listening Based on the bottom-up model for (C)APD, however, executive dysfunction could be a secondary feature but not a primary cause of listening difficulties in (C)APD

Answer 32

Cognition is the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses It is finite When multitasking, no task is performed maximally because of divided attention The net result is the individual has fewer cognitive resources to allocate for either primary or secondary goals Children with hearing loss have to use their cognitive resources to overcome the classroom noise (they will start to have a great difficulty paying attention)

Answer 33

Yes Attention and receptive language weaknesses can play a part too Could manifest as CAPD Less cognitive reserve in these environments to attend to what is said

Answer 34

Recent studies with older adults with hearing loss have shown us that there is at least a correlational if not a causal effect between hearing loss and risk of dementia It's a two-way street

Answer 35

Yes In a study Subjective and objective assessments of auditory processing revealed that the auditory processing ability of children with MMHL was also poorer than that of children with NH Research shows a significant correlation between scores of auditory processing tests and cognitive tasks

Answer 36

Performance IQ Assesses cognitive abilities that do not rely heavily on language skills It measures a person's ability to reason, solve problems, and think abstractly using visual and spatial information

Answer 37

Short term, working, and long-term

Answer 38

Maybe Short term memory is the ability to remember and process information at the same time It is sometimes referred to as "the brain's Post-it note“ It holds a small amount of information (typically ~ 7 +2 items) in an active, readily-available state for a short period of time (typically ~ 10 to 15 seconds or up to a minute) Necessary step toward the next stage (long-term memory)

Answer 39

A system that's designed to manipulate and use short-term memories Manipulating information is essentially the difference between short-term and working memory WM retains and uses, while short-term just retains

Answer 40

Yes Working memory and attention together play a major role in thought processes

Answer 41

Intended for storage of information over a long period of time Motivation is also a consideration (information that is of strong interest to a person is more likely to be retained in long term memory) It is likely that long-term memory decays little over time, and can store unlimited amount of information almost indefinitely There is some debate as to whether humans ever “forget” anything at all, or whether it just becomes increasingly difficult to access/retrieve certain items from memory as seen with aging

Answer 42

Yes And working memory is how you process memory to complete tasks

Answer 43

When they have hearing loss, executive function deficits, or another global condition that accounts for the auditory deficit