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Auditory Processing and Understanding Speech

I think we all know that our hearing tends to get worse as we age. But did you know that a slowdown in auditory processing also contributes to a declining ability to understand speech?

July 2007 - The Aging Auditory System and Understanding Speech - Part 1

September 2007 - The Aging Auditory System, Part 2: Slower Processing and Speech Recognition

September 2007 - Neuroimaging and Cochlear Implants: A Look at How the Brain Hears

September 2007 - The Aging Auditory System, Part 3: Slower Processing, Cognition, and Speech Recognition

November 2007 - Auditory Rehabilitation and the Aging Brain

December 2007 - Mapping the selective brain

January 2008 - How the Auditory Cortex Processes Sound

May 2008 - Peripheral, Central-Auditory, and Cognitive Factors Affecting the Speech-Understanding Problems of Older Adults

June 2008 - Negative Synergy: Hearing Loss and Aging

June 2008 - Changes in Central Auditory Pathway for Tinnitus Sufferers?

July 2008 - Hearing Test May Measure Cognitive Decline

November 2008 - Auditory Processing in Adults: Beyond the Audiogram

February 2009 - I want to party, but my hearing aids won't let me!

February 2009 - Aging Brain May Contribute to Some Hearing Loss

March 2009 - Brain Fitness Exercises Improve Listening

May 2009 - Estrogen Controls How Brain Processes Sound

October 2009 - Can Better Hearing Aids Help You Think Better?

March 2010 - Brain Linked to Hearing Problems at Cocktail Parties

April 2010 - Auditory Processing Disorders in Children

April 2010 - Scanning for Relevant Sound

June 2011 - Spoken-language processing model: a more expansive view to examining auditory processing of spoken language

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The Aging Auditory System and Understanding Speech - Part 1

July 2007

Evidence for slower processing at and below the brainstem level using objective measures

This article is the first of a three-part series on the aging auditory system, and it provides evidence of slower processing from studies that used objective measures unaffected by attention or memory. In the second article, evidence for slower processing within the higher (ie, above the brainstem) auditory pathways is reviewed. Additionally, the relationship between slower processing and speech recognition is examined. In the third article, the complex interrelationships of slower processing, cognition, and speech recognition are examined.

The series is designed to provide an overview of how speech recognition in older individuals is affected by both slower processing and cognition. In particular, such an understanding can lead to more effective aural rehabilitation services for older adults.

http://www.hearingreview.com/issues/articles/2007-07_09.asp

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The Aging Auditory System, Part 2: Slower Processing and Speech Recognition

September 2007

This article is Part 2 of a three-part series on the aging auditory system, and it reviews the evidence for slower processing within the higher (ie, above the brainstem) auditory pathways, whereas Part 1 examined evidence of slower processing from studies that used objective measures unaffected by such things as attention or memory.1 Additionally, the present article will look at the relationship between slower processing and speech recognition. In Part 3, which will be published in next month's HR, the complex interrelationships among slower processing, cognition and speech recognition are examined. It has been generally established that, with aging, individuals experience a decreased ability to recognize rapid speech, even in the presence of normal hearing. The resulting communication difficulties, social isolation, and depression can contribute to an overall decrease in the quality of life.   Full Story

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Neuroimaging and Cochlear Implants: A Look at How the Brain Hears

September 2007

Hearing scientists use neuroimaging techniques, which examine how the brain responds to external acoustic stimuli, to evaluate auditory processing. Investigators may probe how the brain responds to simple manipulations of frequency, intensity, or duration of the stimuli, or they may investigate how the brain responds to more complex listening conditions such as the appreciation of music, the sounds of familiar or unfamiliar languages, or the perception of speech signals in noise. A growing literature focuses on learning how individuals with normal hearing or hearing loss process the sounds in their environment and the sounds needed to communicate. Two uses of neuroimaging techniques are in examining processes contributing to tinnitus and other annoying auditory conditions, and examining conditions in which an acoustic signal is transposed into an electrical stimulus such as a cochlear implant (CI). Several studies with individuals with cochlear implants concentrate on how the brain uses cortical resources to perceive speech or music. This information helps determine ways to improve the integrity of an electrical signal representing speech and to train people with cochlear implants to improve their listening performance  Full Story

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The Aging Auditory System, Part 3: Slower Processing, Cognition, and Speech Recognition

September 2007

In the final article in a three-part series, the author looks at the complex interrelationships between slower processing, cognition, and speech recognition in an effort to determine what this means relative to the elements of a comprehensive aural rehabilitation protocol for adults. With aging, individuals experience a decreased ability to recognize speech, even when they have normal hearing acuity. This difficulty is more obvious when the speech is presented at a fast rate or is presented in the presence of competing signals. Two of the possible underlying mechanisms for poor speech recognition in older individuals include reduced speed of signal processing within the auditory pathways and/or reduced cognition. Parts 1 and 2 of this series of articles presented evidence showing slower processing within the higher auditory pathways and its relationship to speech recognition. Age-related changes in brain structure and function may contribute to poor sensory and cognitive function. Alternatively, cognitive declines may be a consequence of degraded auditory processing, causing sensory deprivation. Thus, a complex inter-relationship among speech recognition, cognitive performance, and slower processing can be expected. Part 3, the final article in the series, examines this complex inter-relationship. An in-depth understanding of these relationships can be expected to lead to more effective aural rehabilitation services for older individuals.  Full Story

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Peripheral, Central-Auditory, and Cognitive Factors Affecting the Speech-Understanding Problems of Older Adults

May 2008

In addition to these two versions of the peripheral hypothesis, the CHABA report identified two potential contributing mechanisms that go beyond the auditory periphery. The first, the central-auditory hypothesis, theorizes age-related deterioration in the ascending pathways of the auditory portions of the central nervous system-from the cochlear nucleus through the primary auditory cortex. The second, the cognitive hypothesis, conjectures age-related declines in amodal processes at the cortical level, such as information storage and retrieval (memory) and attention.  Although both of these hypotheses are "central" or higher-level than the peripheral hypothesis, they differ from each other in at least two important ways. First, the central-auditory hypothesis includes brainstem and cortical structures, whereas the cognitive hypothesis is operational at the cortical level only. Second, the central-auditory hypothesis is modality-specific and plays a role only for the auditory presentation of speech stimuli, whereas the cognitive hypothesis affects mechanisms such as memory, attention, and linguistic knowledge that are not specific to auditory input and may involve many regions of the brain.    Full Story

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Negative Synergy: Hearing Loss and Aging

June 2008

Basic audiometric measures do not offer a comprehensive description of the speech understanding ability or difficulty of patients. Speech understanding is complex and complicated. Individual cognitive abilities (intelligence, language, vocabulary, psychological profile, etc.) as well as audiologic and medical histories, genetic make-up, first- and second-language issues and other factors impact our ability to understand speech, particularly in challenging acoustical environments. . . . This paper will address speech understanding from cognitive (top-down) and sensory-based (bottom-up) perspectives, highlighting the interactive and complimentary relationship required for successful communication.  Full Story

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Hearing Test May Measure Cognitive Decline

July 2008

Central auditory testing may act as an early screen for cognitive decline in the elderly, researchers here said. In a study of 313 patients at least 71 years old, several measures of central auditory processing were impaired in those diagnosed with Alzheimer's disease and, to a lesser extent, those with memory impairment but not meeting criteria for Alzheimer's, reported George A. Gates, M.D., of the University of Washington, and colleagues in the July issue of Archives of Otolaryngology and Head and Neck Surgery. Central auditory processing is the brain function involved in interpreting complex sounds such as speech. "Hearing speech involves detection, recognition, and comprehension, the latter being clearly a cognitive task," said Dr. Gates. Such hearing problems often show up as an inability to understand speech against a background of other conversations, sometimes called the "cocktail party effect." Amplification with hearing aids does not help this form of auditory defect.  Full Story

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Auditory Processing in Adults: Beyond the Audiogram

November 2008

Audiologists are faced daily with patients who report communication issues that they may attribute to hearing loss. These types of communication issues may include difficulty hearing in less than optimal listening situations, reliance on visual information to augment auditory information, a reduced appreciation of listening to music, and difficulty understanding speech when the speaker is unfamiliar. Patients report that these communication issues impact the quality of their lives- often the reason for seeking audiology services. For many of these patients, the results of an audiologic evaluation are consistent with a peripheral hearing loss, and the findings of the evaluation help to direct audiologic treatment to address these communication difficulties or to direct recommendations. However, some patients who present with concerns will demonstrate normal peripheral hearing acuity based on the results of standard audiometric testing. The assumption is often made that because the results of the audiogram are consistent with normal peripheral hearing acuity, the person's reported concerns are not validated. The purpose of this paper is to address the need to look beyond the audiogram to further validate the concerns raised by the patient.   Full Story

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I want to party, but my hearing aids won't let me!

February 2009

Q: I hear that you're doing research on hearing aid use and benefit. Is this true?

A: Well, not exactly... but I want to! My background is in electrical engineering, but for the last 25 years I have been studying hearing and auditory perception. My research has been very basic, though, working to understand how normalhearing, young adults process sound.  I started out studying how we can tell the location of a sound source, and gradually got interested in why "spatial hearing" really seems to matter a lot in everyday settings, like at a cocktail party. The more I looked into these issues, the more I realized that understanding how normal-hearing listeners make sense of sounds at a cocktail party can lead to insights that could allow us to build better hearing aids.1 Lately, I have started studying what happens in "cocktail party" situations to hearing- impaired listeners.  Full Story

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Aging Brain May Contribute to Some Hearing Loss

February 2009

Difficulty recognizing words in loud settings is a common concern for older people, and new research suggests the problem may involve more than hearing loss, but rather age-related structural changes in the brain.  [snip] To gauge the role that age-related brain changes might play in hearing loss, the study authors conducted hearing exercises while using MRI to scan the brains of 18 younger adults between the ages of 19 and 39, and 18 older adults between the ages of 61 and 79. While undergoing the scans, all the participants were tested on their ability to identify certain words, with some words filtered to reduce intelligibility. The researchers found that in "challenging listening conditions," the older adults were generally much worse at recognizing words than younger adults. Even after accounting for the loss of high-frequency hearing that typically accompanies old age, the researchers found that the poorer performance among the older adults was linked to a reduction in the size of small portions of the auditory cortex, a section of gray matter in the brain that controls hearing. This could ultimately explain how and why some hearing problems worsen with age.  Full Story

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Auditory Processing Disorders in Children

April 2010

What is it about hearing that enables us to determine if the lyrics to a Creedence Clearwater Revival song are: "There's a bad moon on the rise" or "There's a bathroom on the right"? How is it possible to have a conversation on a cell phone while riding the noisy MARTA train in downtown Atlanta? How can someone know from which direction a speeding car is approaching in the midst of traffic noise? How can we tell if someone is being serious or just joking when they maintain a straight face? All of these scenarios demonstrate that hearing is not just about soft or loud sounds. It is auditory processing within the brain that makes it possible for us to make sense of the world of sound in which we live - and for children, who are trying to figure out everything all at once, auditory processing is especially important.  Full Story

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Scanning for Relevant Sound

April 2010

Not all hearing impairments arise from problems in the ear itself. Some can stem from issues in the brain. Gaining a deeper understanding of brain-based hearing loss is the aim of Mark Eckert, Ph.D., associate professor in the Department of Otolaryngology Head and Neck Surgery (Hearing Research Program) at the Medical University of South Carolina (MUSC) in Charleston.  Full Story

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Spoken-language processing model: a more expansive view to examining auditory processing of spoken language

June 2011

I would like to first thank Dr. Musiek for this opportunity of sharing my conceptualization of what I refer to as spoken-language processing. Many of you may know that central auditory processing (CAP) has been a subject of heated debate since the early 1970s. Because of the lack of a clear definition of what constitutes CAP, a number of task forces have convened to develop consensus statements and establish best practice principles related to its diagnosis and management.  Full Story