Auditory training and adult rehabilitation:a critical review of the evidence

Auditory Training (AT) describes a regimen of varied listening exercises designed to improve an individual’s ability to perceive speech. The theory of AT is based on brain plasticity (the capacity of neurones in the central auditory system to alter their structure and function) in response to auditory stimulation. The practice of repeatedly listening to the speech sounds included in AT exercises is believed to drive the development of more efficient neuronal pathways, thereby improving auditory processing and speech discrimination. This critical review aims to assess whether auditory training can improve speech discrimination in adults with mild-moderate SNHL. The majority of patients attending Audiology services are adults with presbyacusis and it is therefore important to evaluate evidence of any treatment effect of AT in aural rehabilitation. Ideally this review would seek to appraise evidence of neurophysiological effects of AT so as to verify whether it does induce change in the CAS. However, due to the absence of such studies on this particular patient group, the outcome measure of speech discrimination, as a behavioural indicator of treatment effect is used instead. A review of available research was used to inform an argument for or against using AT in rehabilitative clinical practice. Six studies were identified and although the preliminary evidence indicates an improvement gained from a range of AT paradigms, the treatment effect size was modest and there remains a lack of large-sample RCTs. Future investigation into the efficacy of AT needs to employ neurophysiological studies using auditory evoked potentials in hearing-impaired adults in order to explore effects of AT on the CAS.

Acoustic source characteristics, across-formant integration, and speech intelligibility under competitive conditions

An important aspect of speech perception is the ability to group or select formants using cues in the acoustic source characteristics-for example, fundamental frequency (F0) differences between formants promote their segregation. This study explored the role of more radical differences in source characteristics. Three-formant (F1+F2+F3) synthetic speech analogues were derived from natural sentences. In Experiment 1, F1+F3 were generated by passing a harmonic glottal source (F0 = 140 Hz) through second-order resonators (H1+H3); in Experiment 2, F1+F3 were tonal (sine-wave) analogues (T1+T3). F2 could take either form (H2 or T2). In some conditions, the target formants were presented alone, either monaurally or dichotically (left ear = F1+F3; right ear = F2). In others, they were accompanied by a competitor for F2 (F1+F2C+F3; F2), which listeners must reject to optimize recognition. Competitors (H2C or T2C) were created using the time-reversed frequency and amplitude contours of F2. Dichotic presentation of F2 and F2C ensured that the impact of the competitor arose primarily through informational masking. In the absence of F2C, the effect of a source mismatch between F1+F3 and F2 was relatively modest. When F2C was present, intelligibility was lowest when F2 was tonal and F2C was harmonic, irrespective of which type matched F1+F3. This finding suggests that source type and context, rather than similarity, govern the phonetic contribution of a formant. It is proposed that wideband harmonic analogues are more effective informational maskers than narrowband tonal analogues, and so become dominant in across-frequency integration of phonetic information when placed in competition.

Comparison of software developed for FHR extraction from PCG signals

A valuable alternative to US cardiotocography, for fetal surveillance, can be offered by phonocardiography, a passive and low cost acoustic recording of fetal heart sounds. A crucial point is the exact recognizing of the fetal heart sounds, associated to each fetal heart beat, and then the estimation of FHR signal. In this work, software for FHR assessment from phonocardiographic signals was developed. To check the reliability of the software, obtained results were compared with those of simultaneously recorded cardiotocographic signals. Results seemed to be satisfying, as provided FHR series were almost all confined within FHR-CTG +/- 3 bpm, where FHR-CTG were FHR series provided by commercial US cardiotocographic devices, currently employed in clinical routine.

Exploring novel auditory displays for supporting accelerated skills acquisition and enhanced performance in motorsport

This paper explores the design, development and evaluation of a novel real-time auditory display system for accelerated racing driver skills acquisition. The auditory feedback provides concurrent sensory augmentation and performance feedback using a novel target matching design. Real-time, dynamic, tonal audio feedback representing lateral G-force (a proxy for tire slip) is delivered to one ear whilst a target lateral G-force value representing the ‘limit’ of the car, to which the driver aims to drive, is panned to the driver’s other ear; tonal match across both ears signifies that the ‘limit’ has been reached. An evaluation approach was established to measure the efficacy of the audio feedback in terms of performance, workload and drivers’ assessment of self-efficacy. A preliminary human subject study was conducted in a driving simulator environment. Initial results are encouraging, indicating that there is potential for performance gain and driver confidence enhancement based on the audio feedback.

An algorithm for FHR estimation from foetal phonocardiographic signals

The long-term foetal surveillance is often to be recommended. Hence, the fully non-invasive acoustic recording, through maternal abdomen, represents a valuable alternative to the ultrasonic cardiotocography. Unfortunately, the recorded heart sound signal is heavily loaded by noise, thus the determination of the foetal heart rate raises serious signal processing issues. In this paper, we present a new algorithm for foetal heart rate estimation from foetal phonocardiographic recordings. A filtering is employed as a first step of the algorithm to reduce the background noise. A block for first heart sounds enhancing is then used to further reduce other components of foetal heart sound signals. A complex logic block, guided by a number of rules concerning foetal heart beat regularity, is proposed as a successive block, for the detection of most probable first heart sounds from several candidates. A final block is used for exact first heart sound timing and in turn foetal heart rate estimation. Filtering and enhancing blocks are actually implemented by means of different techniques, so that different processing paths are proposed. Furthermore, a reliability index is introduced to quantify the consistency of the estimated foetal heart rate and, based on statistic parameters; [,] a software quality index is designed to indicate the most reliable analysis procedure (that is, combining the best processing path and the most accurate time mark of the first heart sound, provides the lowest estimation errors). The algorithm performances have been tested on phonocardiographic signals recorded in a local gynaecology private practice from a sample group of about 50 pregnant women. Phonocardiographic signals have been recorded simultaneously to ultrasonic cardiotocographic signals in order to compare the two foetal heart rate series (the one estimated by our algorithm and the other provided by cardiotocographic device). Our results show that the proposed algorithm, in particular some analysis procedures, provides reliable foetal heart rate signals, very close to the reference cardiotocographic recordings. © 2010 Elsevier Ltd. All rights reserved.

A simulating software of fetal phonocardiographic signals

A valuable alternative to traditional diagnostic tool to record fetal heart rate, to monitor the general fetal wellbeing, is fetal phonocardiography, a passive and low cost acoustic recording of fetal heart sounds. In this paper, it is presented a simulating software of fetal phonocardiographic signals relative to different fetal physiological states and recording conditions (for example different kinds and levels of noise). This software can be useful to test and assess fetal heart rate extraction algorithms from fetal phonocardiographic recordings and as a teaching tool for demonstration to medical students and others. © 2010 IEEE.

Case study: auditory brain responses in a minimally verbal child with autism and cerebral palsy

An estimated 30% of individuals with autism spectrum disorders (ASD) remain minimally verbal into late childhood, but research on cognition and brain function in ASD focuses almost exclusively on those with good or only moderately impaired language. Here we present a case study investigating auditory processing of GM, a nonverbal child with ASD and cerebral palsy. At the age of 8 years, GM was tested using magnetoencephalography (MEG) whilst passively listening to speech sounds and complex tones. Where typically developing children and verbal autistic children all demonstrated similar brain responses to speech and nonspeech sounds, GM produced much stronger responses to nonspeech than speech, particularly in the 65–165 ms (M50/M100) time window post-stimulus onset. GM was retested aged 10 years using electroencephalography (EEG) whilst passively listening to pure tone stimuli. Consistent with her MEG response to complex tones, GM showed an unusually early and strong response to pure tones in her EEG responses. The consistency of the MEG and EEG data in this single case study demonstrate both the potential and the feasibility of these methods in the study of minimally verbal children with ASD. Further research is required to determine whether GM's atypical auditory responses are characteristic of other minimally verbal children with ASD or of other individuals with cerebral palsy.

Africa's World Cup:critical reflections on play, patriotism, spectatorship, and space

Africas World Cup: Critical Reflections on Play, Patriotism, Spectatorship, and Space focuses on a remarkable month in the modern history of Africa and in the global history of football. Peter Alegi and Chris Bolsmann are well-known experts on South African football, and they have assembled an impressive team of local and international journalists, academics, and football experts to reflect on the 2010 World Cup and its broader significance, its meanings, complexities, and contradictions. The World Cups sounds, sights, and aesthetics are explored, along with questions of patriotism, nationalism, and spectatorship in Africa and around the world. Experts on urban design and communities write on how the presence of the World Cup worked to refashion urban spaces and negotiate the local struggles in the hosting cities. The volume is richly illustrated by authors photographs, and the essays in this volume feature chronicles of match day experiences; travelogues; ethnographies of fan cultures; analyses of print, broadcast, and electronic media coverage of the tournament; reflections on the World Cups private and public spaces; football exhibits in South African museums; and critiques of the World Cups processes of inclusion and exclusion, as well as its political and economic legacies. The volume concludes with a forum on the World Cup, including Thabo Dladla, Director of Soccer at the University of KwaZulu-Natal, Mohlomi Kekeletso Maubane, a well-known Soweto-based writer and a soccer researcher, and Rodney Reiners, former professional footballer and current chief soccer writer for the Cape Argus newspaper in Cape Town. This collection will appeal to students, scholars, journalists, and fans. Cover illustration: South African fan blowing his vuvuzela at South Africa vs. France, Free State Stadium, Bloemfontein, June 22, 2010. Photo by Chris Bolsmann.

Differing effects of two synthetic phonics programmes on early reading development

Background: Synthetic phonics is the widely accepted approach for teaching reading in English: children are taught to sound out the letters in a word then blend these sounds together. Aims: We compared the impact of two synthetic phonics programmes on early reading.SampleChildren received Letters and Sounds (L&S; 7 schools) which teaches multiple letter-sound mappings or Early Reading Research (ERR; 10 schools) which teaches only the most consistent mappings plus frequent words by sight.MethodWe measured phonological awareness (PA) and reading from school entry to the end of the second (all schools) or third school year (4 ERR, 3 L&S schools). Results: PA was significantly related to all reading measures for the whole sample. However, there was a closer relationship between PA and exception word reading for children receiving the L&S programme. The programmes were equally effective overall, but their impact on reading significantly interacted with school-entry PA: children with poor PA at school entry achieved higher reading attainments under ERR (significant group difference on exception word reading at the end of the first year), whereas children with good PA performed equally well under either programme. Conclusions: The more intensive phonics programme (L&S) heightened the association between PA and exception word reading. Although the programmes were equally effective for most children, results indicate potential benefits of ERR for children with poor PA. We suggest that phonics programmes could be simplified to teach only the most consistent mappings plus frequent words by sight.

The relationship between spoken language and speech and nonspeech processing in children with autism:a magnetic event-related field study

It has been proposed that language impairments in children with Autism Spectrum Disorders (ASD) stem from atypical neural processing of speech and/or nonspeech sounds. However, the strength of this proposal is compromised by the unreliable outcomes of previous studies of speech and nonspeech processing in ASD. The aim of this study was to determine whether there was an association between poor spoken language and atypical event-related field (ERF) responses to speech and nonspeech sounds in children with ASD (n = 14) and controls (n = 18). Data from this developmental population (ages 6-14) were analysed using a novel combination of methods to maximize the reliability of our findings while taking into consideration the heterogeneity of the ASD population. The results showed that poor spoken language scores were associated with atypical left hemisphere brain responses (200 to 400 ms) to both speech and nonspeech in the ASD group. These data support the idea that some children with ASD may have an immature auditory cortex that affects their ability to process both speech and nonspeech sounds. Their poor speech processing may impair their ability to process the speech of other people, and hence reduce their ability to learn the phonology, syntax, and semantics of their native language.

Deconvolution of magnetic acoustic change complex (mACC)

Objective: The aim of this study was to design a novel experimental approach to investigate the morphological characteristics of auditory cortical responses elicited by rapidly changing synthesized speech sounds. Methods: Six sound-evoked magnetoencephalographic (MEG) responses were measured to a synthesized train of speech sounds using the vowels /e/ and /u/ in 17 normal hearing young adults. Responses were measured to: (i) the onset of the speech train, (ii) an F0 increment; (iii) an F0 decrement; (iv) an F2 decrement; (v) an F2 increment; and (vi) the offset of the speech train using short (jittered around 135. ms) and long (1500. ms) stimulus onset asynchronies (SOAs). The least squares (LS) deconvolution technique was used to disentangle the overlapping MEG responses in the short SOA condition only. Results: Comparison between the morphology of the recovered cortical responses in the short and long SOAs conditions showed high similarity, suggesting that the LS deconvolution technique was successful in disentangling the MEG waveforms. Waveform latencies and amplitudes were different for the two SOAs conditions and were influenced by the spectro-temporal properties of the sound sequence. The magnetic acoustic change complex (mACC) for the short SOA condition showed significantly lower amplitudes and shorter latencies compared to the long SOA condition. The F0 transition showed a larger reduction in amplitude from long to short SOA compared to the F2 transition. Lateralization of the cortical responses were observed under some stimulus conditions and appeared to be associated with the spectro-temporal properties of the acoustic stimulus. Conclusions: The LS deconvolution technique provides a new tool to study the properties of the auditory cortical response to rapidly changing sound stimuli. The presence of the cortical auditory evoked responses for rapid transition of synthesized speech stimuli suggests that the temporal code is preserved at the level of the auditory cortex. Further, the reduced amplitudes and shorter latencies might reflect intrinsic properties of the cortical neurons to rapidly presented sounds. Significance: This is the first demonstration of the separation of overlapping cortical responses to rapidly changing speech sounds and offers a potential new biomarker of discrimination of rapid transition of sound.

Across-formant integration and speech intelligibility:effects of acoustic source properties in the presence and absence of a contralateral interferer

The role of source properties in across-formant integration was explored using three-formant (F1+F2+F3) analogues of natural sentences (targets). In experiment 1, F1+F3 were harmonic analogues (H1+H3) generated using a monotonous buzz source and second-order resonators; in experiment 2, F1+F3 were tonal analogues (T1+T3). F2 could take either form (H2 or T2). Target formants were always presented monaurally; the receiving ear was assigned randomly on each trial. In some conditions, only the target was present; in others, a competitor for F2 (F2C) was presented contralaterally. Buzz-excited or tonal competitors were created using the time-reversed frequency and amplitude contours of F2. Listeners must reject F2C to optimize keyword recognition. Whether or not a competitor was present, there was no effect of source mismatch between F1+F3 and F2. The impact of adding F2C was modest when it was tonal but large when it was harmonic, irrespective of whether F2C matched F1+F3. This pattern was maintained when harmonic and tonal counterparts were loudness-matched (experiment 3). Source type and competition, rather than acoustic similarity, governed the phonetic contribution of a formant. Contrary to earlier research using dichotic targets, requiring across-ear integration to optimize intelligibility, H2C was an equally effective informational masker for H2 as for T2.

Cognitive processing in non-communicative patients:what can event-related potentials tell us?

Event-related potentials (ERP) have been proposed to improve the differential diagnosis of non-responsive patients. We investigated the potential of the P300 as a reliable marker of conscious processing in patients with locked-in syndrome (LIS). Eleven chronic LIS patients and 10 healthy subjects (HS) listened to a complex-tone auditory oddball paradigm, first in a passive condition (listen to the sounds) and then in an active condition (counting the deviant tones). Seven out of nine HS displayed a P300 waveform in the passive condition and all in the active condition. HS showed statistically significant changes in peak and area amplitude between conditions. Three out of seven LIS patients showed the P3 waveform in the passive condition and five of seven in the active condition. No changes in peak amplitude and only a significant difference at one electrode in area amplitude were observed in this group between conditions. We conclude that, in spite of keeping full consciousness and intact or nearly intact cortical functions, compared to HS, LIS patients present less reliable results when testing with ERP, specifically in the passive condition. We thus strongly recommend applying ERP paradigms in an active condition when evaluating consciousness in non-responsive patients.