Louise Levy

Hearing and Auditory Processing: Its Importance and Impact on Your Child LOUISE LEVY M.S. AUDIOLOGIST

Contact Information  Louise Levy  863 Park Avenue #1E  New York, New York 10023 212-472-1350 [email protected]

Hearing vs. Auditory Processing

Hearing includes the:  Outer ear and ear canal  Middle ear (eardrum & ossicular chain)  Inner ear (cochlea)

3 TYPES OF HEARING LOSS  Conductive hearing loss  Sensory neural hearing loss  Mixed hearing loss- a combination of both conductive hearing loss and sensory neural hearing loss

Conductive Hearing Loss

 Includes the Outer ear Ear canal Middle ear

External conductive hearing loss  Swimmer’s ear  Q-tip overuse  Wax build up

Causes of Conductive Hearing Loss in the Middle Ear  Anatomy of the middle ear  Eustachian tube dysfunction which then causes FLUID!!!!!!  Allergies to dairy  Disconnect of the ossicular chain

Dairy A study done in the early 1990’s where 90% of ear infections went away when dairy was eliminated

 Dairy and soy have proteins that the body reacts to and can cause fluid

 50% of children react to dairy and soy  Another option may be rice milk….

 Before age 3, 10-20% of children will have at least 3 or more episodes of otitis media….. Department of Education

American Academy OF Otolaryngology and Pediatrics  “distinguish the child with OME who is at risk for speech, language or learning problems from other children with with OME and more promptly evaluate hearing, speech, language and the need for intervention”.

WHEN A CHILD HAS SPECIAL NEEDS… … WE MUST BE MORE AGGRESSIVE AT ELIMINATING FLUID!!!

Sensory Neural Hearing Loss  A Sensory Neural hearing loss is when there has been damage to the hair cells within the cochlea

The hair cells are responsible for detecting pitch specific sounds and sending the auditory stimuli to the brain for decoding

Mixed Hearing Loss  A combination of both a conductive hearing loss and a sensory neural hearing loss

 IF HEARING IS NOT EXCELLENT, STRONG AUDITORY PROCESSING SKILLS WILL NOT DEVELOP……

Auditory processing now takes over…..

AUDITORY PROCESSING IT IS THE CENTRAL NERVOUS SYSTEM AND THE BRAIN THAT MAKES SENSE OF THE INFORMATION SENT FROM THE EAR OR WHAT WE DO WITH WHAT WE HEAR!!!!!

PIC OF CNS AND BRAIN

The Temporal Lobe  The temporal lobe is divided into 2 sections: 1. Left temporal lobe 2. Right temporal lobe The lobes are connected via the corpus callosum, a tract of fibers that are covered in a myelin sheath

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The left side of the temporal lobe specializes in speech and more analytic information The right side of the temporal lobe handles vision and more gestalt information

AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION DEFINES AUDITORY PROCESSING AS LOCALIZATION AUDITORY DISCRIMINATION AUDITORY PATTERN RECOGNITION TEMPORAL DISCRIMINATION DICHOTIC LISTENING/INTEGRATION AUDITORY PERFORMANCE WITH DEGRADED ACOUSTIC SIGNAL

 Processing is defined as neurons firing and creating electrical activity in the brain.

Auditory processing is a deficit in the neural processing which is not due to higher order language, cognition, memory or attention.

The behavioral manifestations of capd often appear as language comprehension disorders

The terms auditory processing and language processing are not interchangeable-where auditory processing stops and language processing begins is still unclear

Children with autism demonstrate abnormalities in auditory processing and receptive language

Children with autism are frequently under reactive and/or hypersensitive to sound and there is often poor auditory processing in contrast to significantly better visual-spatial skills.

Heterogeneity of subjects and test paradigms make it difficult to obtain consistent findings.

It is thought that the brain areas that are activated and therefore the strategies activated are different in autistic children vs. typical children

 There is significant activation of the auditory cortex in the bilateral superior temporal gyrus BUT the activation pattern was different…… there was less activation in the autistic child.

General hypothesis: disturbances in the establishment of neural circuits in the autistic brain

A recent study by J. Gravel Autistic children have difficulty processing auditory information automatically…..therefore they can’t shift their attention easily Implications……

Socialization, cognition and language development such as semantic organization and concept development will be affected

 Can we test auditory processing in the autistic child?

Certain variables need to be present including:  input from the team  appropriate language  within normal cognitive scores

INTERVENTIONS:  SOUND AND LISTENING THERAPUTIC PROGRAMS: TOMATIS  BERARD  LISTENING WITH YOUR WHOLE BODY  THERAPUETIC LISTENING ……. 

AUDITORY CLOSURE  HOME/CLASSROOM MANAGEMENT FM SYSTEMS!!! MINIMIZING BACKGROUND NOISE …T.V. E.G.FISHTANKS/COMPUTERS PREFERENTIAL SEATING SLOW DOWN SPEED OF SPEECH

 We want to improve the signal to noise ratio wherever possible…… …

EAROBICS  Auditory closure  Attention  Rhyming  Sequencing

Interhemispheric Transfer  Computer games that include auditory and video!!!  Music therapy including singing  Listening to a song/asking content questions  Drawing pictures from verbal directions  Simon Says  Brain Gym

Pragmatics and Prosody  Guessing emotions based on intonation  Charades  Reading out loud

Localization  Blind Man’s Bluff  Marco Polo

 GREAT AUDITORY PROCESSING WORKS FOR ALL RELATIONSHIPS!!!!!!