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AUDE 6240 (CAPD) > Lectures 6 & 7: An Overview of CAPD & Professional Guidelines > Flashcards

Lectures 6 & 7: An Overview of CAPD & Professional Guidelines Flashcards

1
Q

what is CAPD

A

Complex & heterogeneous disorder. It is a sensory processing deficit that commonly impacts listening, spoken language, comprehension, and learning. When auditory skills are weak, children may experience auditory overload. CAPD is an input disorder that impedes selective and divided auditory attention. Most Children with auditory processing problems have normal intelligence and normal hearing sensitivity.

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2
Q

ASHA 1996 Defined auditory processing in terms of performance on a specific group of auditory tasks including

A

Perception of sound (first step)
Clarification of sound
Localization and lateraliztation of sound
Attending to sound
Analyzing, storing, retrieving information (memory)
Integration of message (what is the message, any visuals associated with it)
Auditory performance with competing and degraded acoustic signals

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3
Q

asha 1996 processes of temporal features of sound include

A

Temporal integration or summation (combing or adding sounds)
Temporal resolution or discrimination (GDT - how big does the gap have to be to recognize there are 2 signals and not one)
Large gap = poorer GD
Smaller gap = better GD
Temporal ordering or sequencing (like with phone numbers, addresses, passwords etc.)
Temporal masking (forward and backward)

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4
Q

what was ASHA’s technical report 2005

A

CAPD refers to the efficiency and effectiveness in which the CANS utilizes auditory information
how efficiently do you proess sounds you are getting from the periphery

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5
Q

Certain auditory skills develop in a sequence but they are also interconnected and contribute to effective auditory processing as a whole based on

A

Depends on neuromaturation (auditory skills improve as a child’s brain matures and impacts how they can process sounds)
Children need a 10-15 dB SNR w/ typical hearing
Children with HL needs 20-25dB SNR

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6
Q

what is sensation

A

ability to identify the presence of sound
Have to realize there is sound in the environment before you can do anything with it

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7
Q

localization

A

where the sound is coming from

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8
Q

Auditory resolution/discrimination

A

Ability to discriminate between sounds that differ in frequency, duration, and intensity

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9
Q

Ability to discriminate between sounds that differ in frequency, duration, and intensity

A

auditory resolution/discrimination

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10
Q

problems with auditory resolution/discrimination

A

Problems with auditory discrimination can result in academic difficulty such as following directions, reading, spelling, and writing skills

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11
Q

ability to attend to relevant acoustic signals, such as speech and sustain that attention for an age-appropriate amount of time

A

auditory attention

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12
Q

auditory attention

A

ability to attend to relevant acoustic signals, such as speech and sustain that attention for an age-appropriate amount of time

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13
Q

ability to identify the primary linguistic or non-linguistic sound source from background noise

A

auditory figure ground

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14
Q

auditory figure ground

A

ability to identify the primary linguistic or non-linguistic sound source from background noise

For example, in a classroom, the teacher’s voice is the primary signal other sounds/noises in the room are the competing noise

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15
Q

Ability to understand whole word or message when part is missing
Helps to fill in the blanks and understand the messages
Easier for adults with rich language base/experience than children who are building language skills

A

auditory closure

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16
Q

auditory closure

A

Ability to understand whole word or message when part is missing
Helps to fill in the blanks and understand the messages
Easier for adults with rich language base/experience than children who are building language skills

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17
Q

Important for distinguishing verb tenses and other morphological markers that may be acoustically distorted or masked by background noise

A

auditory analysis

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18
Q

Important for distinguishing verb tenses and other morphological markers that may be acoustically distorted or masked by background noise

A

auditory analysis

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19
Q

smallest unit of speech sound used to form meaningful contrasts between utterances

A

phoneme

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20
Q

smallest unit of meaning in a language; doesn’t have to be a word

A

Morpheme:

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21
Q

fxns as the foundation of language

A

morphem

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22
Q

Ability to blend phonemes into words
Critical for reading

A

auditory synthesis

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23
Q

auditory synthesis

A

Ability to blend phonemes into words
Critical for reading

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24
Q

Ability to attach meaning to sound
Fundamental for developing auditory memory

A

auditory association

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25
auditory association
Ability to attach meaning to sound Fundamental for developing auditory memory
26
Recall of an acoustic signal after it has been labeled and stored Requires remembering and recalling various acoustic stimuli of different lengths & numbers Overall memory issues can affect this
auditory memory
27
auditory memory
Recall of an acoustic signal after it has been labeled and stored Requires remembering and recalling various acoustic stimuli of different lengths & numbers Overall memory issues can affect this
28
auditory sequential memory
ability to recall order of a series of acoustic stimuli
29
ability to recall order of a series of acoustic stimuli
auditory sequential memory
30
ability to retain and recall auditory information as it is immediately presented
auditory short term memory
31
auditory short term memory
ability to retain and recall auditory information as it is immediately presented
32
temporal integration
ability of the auditory system, specifically the auditory nerve and CANS, to integrate inputs over time, which in a variety of real-world circumstances, enhances the detection and/or discrimination of a sound
33
ability of the auditory system, specifically the auditory nerve and CANS, to integrate inputs over time, which in a variety of real-world circumstances, enhances the detection and/or discrimination of a sound
temporal integration
34
Lowest absolute threshold
200-300ms
35
Tenfold increase in duration
10dB improvement in threshold
36
Tonal durations >300ms doesn’t improve threshold due to
adaptation
37
detection of small timing differences when processing speech
temporal resolution
38
temporal resolution
detection of small timing differences when processing speech
39
smallest amunt of silence between two signals detected by listener
gdt
40
GDT
smallest amunt of silence between two signals detected by listener
41
inability to hear subtle acoustic changes that can impact speech perception
poor GD
42
what is temporal masking
Delay between masker and signal Done using louder, longer vowel sounds that can swamp softer, shorter consonant sounds Forward (signal follows masker; masker first) & backward (signal precede masker; masker second)
43
(signal follows masker; masker first
forward masking
44
signal precede masker; masker second)
backward masking
45
why do we need two ears
Two ears are better than one Able to detect frequency and intensity differences better Threshold for spondees and pure tones are better by around 3dB due to binaural summation Speech intelligibility is better especially in noise (precedence effect, MLD, & perceptual coherence)
46
Auditory overload is experienced when
auditory skills are weak Too much auditory stimuli causes this
47
facotrs that contribute to overload
Fast speaking rate Increased phonetic complexity (context, syntax, etc.) Increased acoustic/phonetic similarity Rhyming words (might not enjoy nursery rhymes) Reduced context Linguistic, visual, and/or situational context are reduced Poor listening conditions Noisy backgrounds, increased distance from speaker, reverberation Temporal distortions Demand for verbatim retention or recall give someone 3 words and after a period of time they have to repeat them back in the right order
48
CAPD tests are directed to assess
normal auditory processing function and assess the system when in auditory overload
49
what are the two opposing views to capd
general auditory hypothesis language-specific hypothesis
50
General auditory hypothesis
Deficits in higher order auditory processing of varying acoustic signals; PRIMARILY auditory modality deficit
51
language specific hypothesis
Processing deficit is phonetic/language-based, not specifically auditory in nature
52
categories of APD
developmental acquired secondary
53
Cases presenting in childhood with normal hearing (i.e., normal audiometry) and no other known etiology or potential risk factors Some individuals may retain APD into adulthood
developmental apd
54
Cases associated with a known post-natal event (e.g., neurological trauma or infection) that could plausibly explain the APD
acquired apd
55
Cases where APD occurs in the presence, or as a result, of peripheral hearing impairment (e.g., presbycusis or congenital SNHL) This includes transient hearing impairment after its resolution (e.g., glue ear or surgically corrected otosclerosis)
secondary apd
56
nonacademic profile
May appear hearing impaired but hearing sensitivity is normal History of chronic or recurrent OME Repeatedly saying “huh” or “what” and asking people to repeat Poor sound localization May have poor music skills and difficulty learning rhymes and songs (poor phonemic awareness/processing?) May have problems with fine and gross motors skill May exhibit behavioral problems
57
how can any of the nonacademic profiles be exaggerated
can be exaggerated in noise and/or with degraded acoustic stimuli
58
academic profile
Almost all kids referred for CAPD evals are struggling academically Child not working up to his/her potential Doing poorly in schoolwork and/or not testing well Weakness in spelling, reading, and/or writing Strong math skills (except when reading is involved) Difficulty following instruction/multistep instructions Failed or failing a grade Significant scatter in ability, intelligence, or performance on achievement, psychological, and language tests often with weakness in auditory domains Better performance on non-auditory tasks Verbal IQ score lower than performance IQ
59
academic struggles
Child receives Cs (if IQ > 95) or Ds and Fs (if IQ > 80) Does not meet basic curriculum requirements with an IQ > 80 to 85 First or second grader reading well but no comprehension of the material Works long hours but only gets b or cs Demonstrates excessive frustration with homework
60
Average IQ
85-115
61
what is the SD of IQ
15
62
CAPD diagnostic criteria for cognition
Cognitive abilities are assessed Intellegicne shouldn’t be a facoor because a child with reduced intellectual abilities also demonstrates reduced auditory processing skills
63
CAPD diagnostic criteria for S/L
Minimum language age should be >/= 6yrs or within a year of chronological age of language development Variability of auditory skill maturity in children < 6 years of age is too diverse, which makes reliable testing and, therefore, diagnosis of (C)APD difficult before age 7 English as a primary language A diverse language background may affect test interpretation and results Intelligible speech Most tests need a verbal response You have to understand what they are saying in order to reliably test and interpret
64
hearing sensitivity criteria for CAPD testing
NORMAL in both ears Significant ME dysfunction (effusion or infection) Can test after they recover Affects results
65
Rule out other disabilities before testing for CAPD
true
66
The following conditions should be identified before capd testingg
ADHD or executive function deficits Language and phonological processing problems Learning delay/disability Cognitive impairment Autism and autism spectrum disorders
67
(C)APD should be an exclusionary diagnosis
tru
68
subtypes of CAPD
Lexical Decoding Deficits (most common type) Tolerance-Fading Memory (TFM) (second most common) Organizational Deficits or Output-Organization Deficit Integration Deficits
69
Lexical Decoding Deficits (most common type)
Issues processing words verbally and written Difficulty manipulating sound, difficulty decoding accuracy, speed or both Cannot decode phonemes Differential diagnosis = ADHD Site of lesion - left posterior temporal lobe
70
Tolerance-Fading Memory (TFM) (second most common)
Issues hearing in noise, information fades quickly from short term memory Weak expressive language and poor handwriting Weak expressive language and poor handwriting Comorbidity with CAPD & ADHD (existing together) Site of lesion: frontal and anterior temporal lobes
71
Organizational Deficits or Output-Organization Deficit
Issues with anything sequential or planning (numbers) Disorganized at home or school (messy desk, messy room, etc.) will be seen with one of the other subtypes and not on its own Site of lesion - anterior temporal lobe
72
Integration Deficits
Difficulty integrating acoustic and visual information Long delays in response to auditory stimuli, writing and use of language LE deficits in dichotic tests with language based responses REA larger than normal past 11-12 with verbal tasks Acoustic and visual deficits Processing delays Site of lesion: integration deficits at the CC
73
REA
74
first cross-over in the auditory system is at the
SOC
75
right ear crossed pathway has direct input to the left hemisphere, which is predominant for language
true REA
76
Information from the left contralateral pathway (already crossed to the right side) has to cross over again through the corpus callosum to get to the left hemisphere for language processing
true
77
The REA is normal in children, typically up to ~ years, due to neuromaturation effects
11 to 12
78
ome evidence to suggest that males have a smaller/not as robust corpus callosum
true
79
According to some studies, that may be the reason why males may a higher ratio than females for developmental disorders such as
Language problems Dyslexia (C)APD Learning delays ADHD
80
Genetic predisposition
multifactorial
81
incidence
new cases
82
prevalence
existing cases in a time period or popultation
83
influence of environment and genetics more than one gene involved
multifactorial
84
C)APD is a
neural processing deficit of auditory stimuli
85
exact etiology of (C)APD is known
false unk own
86
Comorbidity is common with
ADHD Phonological processing and language deficits Reading and spelling problems Learning delays
87
(C)APD is, however, not the result of dysfunction in other modalities
true
88
Some professionals do not recognize (C)APD as a distinct clinical entity unique to the auditory system
true
89
Developmental (C)APD is controversial
true
90
Lax criterion will yield
better sensitivity but poorer specificity
91
Strict criterion will yield
better specificity but poorer sensitivity
92
lax criteria
As size of the test battery increases, greater probability that a patient will fail any single test It improves sensitivity but can undermine specificity as normal patients have an increased chance of being incorrectly identified for ex: PT is more likely to fail one test when a battery has 10 tests as compared to when it has 2-4 tests
93
intermediate criteria
Most reliable criteria Abnormal performance on at least 2 tests (> 2 SD below mean) Abnormal performance on at least 1 test (> 3 SD below mean)
94
strict criteria
As size of the test battery increases, less probability that a patient will fail all tests Beneficial for detecting normal function and improves specificity but can undermine sensitivity as patients with abnormal function will be less likely to fail the entire battery when more tests are included For example, a patient is more likely to fail all tests when a battery has 2 to 3 tests as compared to when it has 10 tests

AUDE 6240 (CAPD) (9 decks)

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