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BACKGROUND: The aim of the study was to determine the link between frequency of optimal respiratory-swallow coordination, swallowing impairment, and airway invasion in head and neck cancer (HNC) patients. METHOD: A cross-sectional study of a heterogeneous group of HNC patients (49), precancer (N = 30) or postcancer treatment (N = 29), participated in a single Modified Barium Swallow Study (MBSS) with synchronized respiratory data. RESULTS: Spearman correlation coefficients revealed significant negative correlations between optimal respiratory-swallow phase pattern and objective measures of swallowing impairment: penetration-aspiration scale max, pharyngeal total, and oral total scores with Spearman correlation coefficients of −0.53 (z .001), −0.50 (P < .001), and −0.43 (P = .002), respectively. Optimal respiratory-swallow pattern was significantly decreased (P = .03) in patients after cancer treatment compared with another patient group before cancer treatment. CONCLUSION: These findings indicate that as the percentage of optimal respiratory-swallow phase patterns increase, swallowing impairment decreases in the HNC patient population.

Automaticity, the ability to perform a task rapidly with minimal effort, plays a key role in reading fluency and is indexed by rapid automatized naming (RAN) and processing speed. Yet little is known about automaticity’s neurophysiologic underpinnings. The more efficiently sound is encoded, the more automatic sound processing can be. In turn, this automaticity could free up cognitive resources such as attention and working memory to help build an integrative reading network. Therefore, we hypothesized that automaticity and reading fluency correlate with stable neural representation of sounds, given a larger body of literature suggesting the close relationship between neural stability and the integrative function in the central auditory system. To test this hypothesis, we recorded the frequency-following responses (FFR) to speech syllables and administered cognitive and reading measures to school-aged children. We show that the stability of neural responses to speech correlates with RAN and processing speed, but not phonological awareness. Moreover, the link between neural stability and RAN mediates the previously-determined link between neural stability and reading ability. Children with a RAN deficit have especially unstable neural responses. Our neurophysiological approach illuminates a potential neural mechanism specific to RAN, which in turn indicates a relationship between synchronous neural firing in the auditory system and automaticity critical for reading fluency.

Speech perception relies on a listener's ability to simultaneously resolve multiple temporal features in the speech signal. Little is known regarding neural mechanisms that enable the simultaneous coding of concurrent temporal features in speech. Here we show that two categories of temporal features in speech, the low-frequency speech envelope and periodicity cues, are processed by distinct neural mechanisms within the same population of cortical neurons. We measured population activity in primary auditory cortex of anesthetized guinea pig in response to three variants of a naturally produced sentence. Results show that the envelope of population responses closely tracks the speech envelope, and this cortical activity more closely reflects wider bandwidths of the speech envelope compared to narrow bands. Additionally, neuronal populations represent the fundamental frequency of speech robustly with phase-locked responses. Importantly, these two temporal features of speech are simultaneously observed within neuronal ensembles in auditory cortex in response to clear, conversation, and compressed speech exemplars. Results show that auditory cortical neurons are adept at simultaneously resolving multiple temporal features in extended speech sentences using discrete coding mechanisms.

Background We aimed to define normative values for novel pressure topography metrics for high-resolution pharyngeal-esophageal manofluorography. The effects of age, gender, and bolus properties were examined. Methods Concurrent high-resolution manometry (HRM) and videofluoroscopy data were collected from 22 younger (aged 21–40) and 22 older (aged 60–80) healthy subjects. Pressure topography was analyzed by correlating pressure domains with videofluoroscopic events. Nine pressure topography metrics of the pharyngeal and proximal esophageal swallow were extracted; four of these were also compared with previously obtained esophageal HRM studies to assess the effects of catheter diameter. Key Results Older individuals exhibited more vigorous contractility in the pharynx than did younger subjects with all bolus types, but the greatest values for both groups were with effortful swallow and on that measure the age groups were similar. Upper esophageal sphincter (UES) intrabolus pressure during sphincter opening was also greater in the older subjects. Some gender differences were observed, particularly related to proximal esophageal contractile vigor. Bolus consistency had no consistent effect. Studies using the larger catheter diameter resulted in significantly greater contractile vigor in the UES and proximal esophagus. Conclusions & Inferences Older adults exhibited more vigorous pharyngeal contractions than young adults, albeit within a similar range of capacity, perhaps reflecting a compensatory response to other age-related physiological changes. Greater UES intrabolus pressures observed during bolus transit in the older group likely reflect reduced UES compliance with age. Normative data on novel HRM metrics collected in this study can serve as a reference for future clinical studies.

Background Patients treated for head and neck cancer frequently develop dysphagia. Bolus characteristics are altered during fluoroscopic swallowing studies to observe the impact on swallowing function. The purpose of this study was to determine bolus volume and consistency effects on oropharyngeal swallowing physiology and patient awareness of swallowing difficulty. Methods Twenty-one patients with head and neck cancer were assessed pre-chemoradiation and post-chemoradiation. The Modified Barium Swallow Study (MBSS) was utilized to examine swallow physiology. Each patient provided perceptual ratings of swallowing difficulty after each swallow of varying bolus types. Results Oral transit times were significantly longer with pudding boluses. There were trends for higher residue percentages as well as perceptual ratings for pudding and cookie boluses. One correlation between perceptual ratings and physiology was significant. Conclusion Patient awareness of swallowing difficulty and aspects of swallowing physiology vary with bolus consistency. Patient awareness does not correlate with observed changes in swallowing physiology. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1122–1129, 2015

Patients treated with chemoradiation for head and neck cancer often report difficulty with swallowing and are frequently diagnosed with dysphagia. The extent to which patient awareness of dysphagia corresponds to observed physiologic changes in swallowing is unclear. The purpose of this study was to determine how both patient awareness of swallowing function and swallowing physiology individually change following chemoradiation and then to clarify the relationship between them. Twenty-one patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with twenty-one control subjects. The modified barium swallow test was utilized to examine swallowing physiology. Each subject was also given a series of items regarding awareness of specific dysphagia symptoms. Results showed decreased swallow efficiencies, higher percentages of residue, and more occurrences of penetration and aspiration following chemoradiation. Patients also had significantly higher ratings for 4 of the 12 items ("dry mouth," "food sticking in my mouth," "need water to help food go down," and "change in sense of taste"). Only one strong and significant correlation was found between ratings for "I have difficulty swallowing" and swallow efficiency values. Based on these findings, it appears that patients sense a general difficulty with swallowing but have less awareness of specific symptoms of dysphagia.

Patients treated with chemoradiation for head and neck cancer frequently develop dysphagia. Tissue damage to the oral tongue causing weakness along with decreases in saliva production may contribute to dysphagia. Yet, effects of these variables on swallowing-related measures are unclear. The purpose of this study was (1) to determine effects of chemoradiation on tongue pressures, as a surrogate for strength, and salivary flow rates and (2) to elucidate relationships among tongue pressures, saliva production, and swallowing efficiency by bolus type. Twenty-one patients with head and neck cancer treated with chemoradiation were assessed before and after treatment and matched with 21 healthy control participants who did not receive chemoradiation. Each participant was given a questionnaire to rate dysphagia symptoms. Videofluoroscopic Evaluation of Swallowing (VFES) was used to determine swallowing efficiency; the Saxon test measured salivary flow rate; and the Iowa Oral Performance Instrument (IOPI) was used for oral tongue maximum and endurance measures. Results revealed significantly lower tongue endurance measures for patients post-treatment as compared to controls (p = .012). Salivary flow rates also were lower compared to pre-treatment (p = .000) and controls (p = .000). Simple linear regression analyses showed that change in salivary flow rate was predictive of change in swallow efficiency measures from pre- to post-treatment for 1 mL thin liquid (p = .017), 3 mL nectar-thick liquid (p = .026), and 3 mL standard barium pudding (p = .011) boluses. Based on these findings, it appears that chemoradiation treatment affects tongue endurance and salivary flow rate, and these changes may impact swallow efficiency. These factors should be considered when planning treatment for dysphagia.

Children with dyslexia often exhibit increased variability in sensory and cognitive aspects of hearing relative to typically developing peers. Assistive listening devices (classroom FM systems) may reduce auditory processing variability by enhancing acoustic clarity and attention. We assessed the impact of classroom FM system use for 1 year on auditory neurophysiology and reading skills in children with dyslexia. FM system use reduced the variability of subcortical responses to sound, and this improvement was linked to concomitant increases in reading and phonological awareness. Moreover, response consistency before FM system use predicted gains in phonological awareness. A matched control group of children with dyslexia attending the same schools who did not use the FM system did not show these effects. Assistive listening devices can improve the neural representation of speech and impact reading-related skills by enhancing acoustic clarity and attention, reducing variability in auditory processing.

OBJECTIVES The purpose of this study was to obtain behavioral hearing thresholds for frequencies between 0.125 and 20 kHz from a large population between 10 and 65 yr old using a clinically feasible calibration method expected to compensate well for variations in the distance between the eardrum and an insert-type sound source. Previous reports of hearing thresholds in the extended high frequencies (>8 kHz) have either used calibration techniques known to be inaccurate or specialized equipment not suitable for clinical use. DESIGN Hearing thresholds were measured from 352 human subjects between 10 and 65 yr old having clinically normal-hearing thresholds (

Low frequency temporal information present in speech is critical for normal perception, however the neural mechanism underlying the differentiation of slow rates in acoustic signals is not known. Data from the rat trigeminal system suggest that the paralemniscal pathway may be specifically tuned to code low-frequency temporal information. We tested whether this phenomenon occurs in the auditory system by measuring the representation of temporal rate in lemniscal and paralemniscal auditory thalamus and cortex in guinea pig. Similar to the trigeminal system, responses measured in auditory thalamus indicate that slow rates are differentially represented in a paralemniscal pathway. In cortex, both lemniscal and paralemniscal neurons indicated sensitivity to slow rates. We speculate that a paralemniscal pathway in the auditory system may be specifically tuned to code low frequency temporal information present in acoustic signals. These data suggest that somatosensory and auditory modalities have parallel sub-cortical pathways that separately process slow rates and the spatial representation of the sensory periphery.

Children with reading impairments have deficits in phonological awareness, phonemic categorization, speech-in-noise perception, and psychophysical tasks such as frequency and temporal discrimination. Many of these children also exhibit abnormal encoding of speech stimuli in the auditory brainstem, even though responses to click stimuli are normal. In typically developing children the auditory brainstem response reflects acoustic differences between contrastive stop consonants. The current study investigated whether this subcortical differentiation of stop consonants was related to reading ability and speech-in-noise performance. Across a group of children with a wide range of reading ability, the subcortical differentiation of 3 speech stimuli ([ba], [da], [ga]) was found to be correlated with phonological awareness, reading, and speech-in-noise perception, with better performers exhibiting greater differences among responses to the 3 syllables. When subjects were categorized into terciles based on phonological awareness and speech-in-noise performance, the top-performing third in each grouping had greater subcortical differentiation than the bottom third. These results are consistent with the view that the neural processes underlying phonological awareness and speech-in-noise perception depend on reciprocal interactions between cognitive and perceptual processes.

This study provides new evidence of deficient auditory cortical processing of speech in noise in autism spectrum disorders (ASD). Speech-evoked responses (approximately 100-300 ms) in quiet and background noise were evaluated in typically-developing (TD) children and children with ASD. ASD responses showed delayed timing (both conditions) and reduced amplitudes (quiet) compared to TD responses. As expected, TD responses in noise were delayed and reduced compared to quiet responses. However, minimal quiet-to-noise response differences were found in children with ASD, presumably because quiet responses were already severely degraded. Moreover, ASD quiet responses resembled TD noise responses, implying that children with ASD process speech in quiet only as well as TD children do in background noise.

Although it is largely agreed that phonological processing deficits are a major cause of poor reading, the neural origins of phonological processing are not well understood. We now show, for the first time, that phonological decoding, measured with a test of single-nonword reading, is significantly correlated with the timing of subcortical auditory processing and also, to a lesser extent, with the robustness of subcortical representation of the harmonic content of speech, but not with pitch encoding. The relationships we observe between reading and subcortical processing fall along a continuum, with poor readers at one end and good readers at the other. These data suggest that reading skill may depend on the integrity of subcortical auditory mechanisms and are consistent with the idea that subcortical representation of the acoustic features of speech may play a role in normal reading as well as in the development of reading disorders. These data establish a significant link between subcortical auditory function and reading, thereby contributing to the understanding of the biological bases of reading. At a more general level, these findings are among the first to establish a direct relationship between subcortical sensory function and a specific cognitive skill (reading). We argue that this relationship between cortical and subcortical function could be shaped during development by the corticofugal pathway and that this cortical-subcortical link could contribute to the phonological processing deficits experienced by poor readers.

Objective The purpose of this study is to expand our understanding of how the human auditory brainstem encodes temporal and spectral acoustic cues in voiced stop consonant–vowel syllables. Methods Auditory evoked potentials measuring activity from the brainstem of 22 normal learning children were recorded to the voiced stop consonant syllables [ga], [da], and [ba]. Spectrotemporal information distinguishing these voiced consonant–vowel syllables is contained within the first few milliseconds of the burst and the formant transition to the vowel. Responses were compared across stimuli with respect to their temporal and spectral content. Results Brainstem response latencies change in a predictable manner in response to systematic alterations in a speech syllable indicating that the distinguishing acoustic cues are represented by neural response timing (synchrony). Spectral analyses of the responses show frequency distribution differences across stimuli (some of which appear to represent acoustic characteristics created by difference tones of the stimulus formants) indicating that neural phase-locking is also important for encoding these acoustic elements. Conclusions Considered within the context of existing knowledge of brainstem encoding of speech–sound structure, these data are the beginning of a comprehensive delineation of how the human auditory brainstem encodes perceptually critical features of speech. Significance The results of this study could be used to determine how neural encoding is disrupted in the clinical populations for whom stop consonants pose particular perceptual challenges (e.g., hearing impaired individuals and poor readers).

Objective Deficient prosody is a hallmark of the pragmatic (socially contextualized) language impairment in Autism Spectrum Disorders (ASD). Prosody communicates emotion and intention and is conveyed through acoustic cues such as pitch contour. Thus, the objective of this study was to examine the subcortical representations of prosodic speech in children with ASD. Methods Using passively evoked brainstem responses to speech syllables with descending and ascending pitch contours, we examined sensory encoding of pitch in children with ASD who had normal intelligence and hearing and were age-matched with typically developing (TD) control children. Results We found that some children on the autism spectrum show deficient pitch tracking (evidenced by increased Frequency and Slope Errors and reduced phase locking) compared with TD children. Conclusions This is the first demonstration of subcortical involvement in prosody encoding deficits in this population of children. Significance Our findings may have implications for diagnostic and remediation strategies in a subset of children with ASD and open up an avenue for future investigations.

Cortical analysis of speech has long been considered the domain of left-hemisphere auditory areas. A recent hypothesis poses that cortical processing of acoustic signals, including speech, is mediated bilaterally based on the component rates inherent to the speech signal. In support of this hypothesis, previous studies have shown that slow temporal features (3–5 Hz) in nonspeech acoustic signals lateralize to right-hemisphere auditory areas, whereas rapid temporal features (20–50 Hz) lateralize to the left hemisphere. These results were obtained using nonspeech stimuli, and it is not known whether right-hemisphere auditory cortex is dominant for coding the slow temporal features in speech known as the speech envelope. Here we show strong right-hemisphere dominance for coding the speech envelope, which represents syllable patterns and is critical for normal speech perception. Right-hemisphere auditory cortex was 100% more accurate in following contours of the speech envelope and had a 33% larger response magnitude while following the envelope compared with the left hemisphere. Asymmetries were evident regardless of the ear of stimulation despite dominance of contralateral connections in ascending auditory pathways. Results provide evidence that the right hemisphere plays a specific and important role in speech processing and support the hypothesis that acoustic processing of speech involves the decomposition of the signal into constituent temporal features by rate-specialized neurons in right- and left-hemisphere auditory cortex.

Research demonstrates that varying sensory input, including the characteristics of a bolus, changes swallow physiology. Altering the consistency of fluids is a common compensatory technique used in dysphagia management to facilitate change. However, it is not known what variations in viscosity can be perceived in the oral cavity or oropharynx or if age affects oral and oropharyngeal perceptions of fluid viscosity. This study aims to establish the ability of normal adults to perceive fluid viscosity in the oral cavity and oropharynx and to determine if, within this population, there are age-related changes in oral and oropharyngeal perceptions. Sensitivity was established by deriving the exponent for the psychophysical law for fluid viscosity in both the oral cavity and the oropharynx, using modulus-free magnitude estimation with Newtonian fluids of corn syrup and water. Sixty normal volunteers, aged 21-84 years, participated. Results indicate that the exponent for oral perception of fluid viscosity was 0.3298, while for oropharyngeal perception it was 0.3148. Viscosity perception deteriorates with increasing age. Men exhibited a more marked deterioration in sensitivity than women. This study contributes to the literature on oral and oropharyngeal perceptions and on aging. The results provide a basis for work with individuals with dysphagia.

Learning to read is a fundamental developmental milestone, and achieving reading competency has lifelong consequences. Although literacy development proceeds smoothly for many children, a subset struggle with this learning process, creating a need to identify reliable biomarkers of a child’s future literacy that could facilitate early diagnosis and access to crucial early interventions. Neural markers of reading skills have been identified in school-aged children and adults; many pertain to the precision of information processing in noise, but it is unknown whether these markers are present in pre-reading children. Here, in a series of experiments in 112 children (ages 3–14 y), we show brain–behavior relationships between the integrity of the neural coding of speech in noise and phonology. We harness these findings into a predictive model of preliteracy, revealing that a 30-min neurophysiological assessment predicts performance on multiple pre-reading tests and, one year later, predicts preschoolers’ performance across multiple domains of emergent literacy. This same neural coding model predicts literacy and diagnosis of a learning disability in school-aged children. These findings offer new insight into the biological constraints on preliteracy during early childhood, suggesting that neural processing of consonants in noise is fundamental for language and reading development. Pragmatically, these findings open doors to early identification of children at risk for language learning problems; this early identification may in turn facilitate access to early interventions that could prevent a life spent struggling to read., The neural coding of consonants in noise predicts early literacy skills in pre-reading children, providing a biological marker that may help to target early intervention., Author Summary Learning to read is a chief developmental milestone with lifelong consequences; although there are effective interventions for struggling readers, an ongoing challenge has been to identify candidates for intervention at a young-enough age. We measured the precision of the neural coding of consonants in noise, and found that pre-reading children (4 y old) with stronger neural processing had superior early literacy skills; one year later they were also stronger emerging readers. We applied the same neural coding measure to a cohort of older children: in addition to predicting these children’s literacy achievement, we could reliably predict which of the children had received a diagnosis of a reading impairment. Taken together, these results suggest that the neural coding of speech in noise plays a fundamental role in language development. Children who struggle to listen in noisy environments may struggle to make meaning of the language they hear on a daily basis, which can in turn set them at risk for literacy challenges. Evaluating the neural coding of speech in noise may provide an objective neurophysiological marker for these at-risk children, opening a door to early and specific interventions that may stave off a life spent struggling to read.

The search for a unique biological marker of language-based learning disabilities has so far yielded inconclusive findings. Previous studies have shown a plethora of auditory processing deficits in learning disabilities at both the perceptual and physiological levels. In this study, we investigated the association among brainstem timing, cortical processing of stimulus differences, and literacy skills. To that end, brainstem timing and cortical sensitivity to acoustic change [mismatch negativity (MMN)] were measured in a group of children with learning disabilities and normal-learning children. The learning-disabled (LD) group was further divided into two subgroups with normal and abnormal brainstem timing. MMNs, literacy, and cognitive abilities were compared among the three groups. LD individuals with abnormal brainstem timing were more likely to show reduced processing of acoustic change at the cortical level compared with both normal-learning individuals and LD individuals with normal brainstem timing. This group was also characterized by a more severe form of learning disability manifested by poorer reading, listening comprehension, and general cognitive ability. We conclude that abnormal brainstem timing in learning disabilities is related to higher incidence of reduced cortical sensitivity to acoustic change and to deficient literacy skills. These findings suggest that abnormal brainstem timing may serve as a reliable marker of a subgroup of individuals with learning disabilities. They also suggest that faulty mechanisms of neural timing at the brainstem may be the biological basis of malfunction in this group.

Objectives: Some children with learning problems (LP) experience speech-sound perception deficits that worsen in background noise. The first goal was to determine whether these impairments are associated with abnormal neurophysiologic representation of speech features in noise reflected at brain-stem and cortical levels. The second goal was to examine the perceptual and neurophysiological benefits provided to an impaired system by acoustic cue enhancements. Methods: Behavioral speech perception measures (just noticeable difference scores), auditory brain-stem responses, frequency-following responses and cortical-evoked potentials (P1, N1, P1 0 ,N 1 0 ) were studied in a group of LP children and compared to responses in normal children. Results: We report abnormalities in the fundamental sensory representation of sound at brain-stem and cortical levels in the LP children when speech sounds were presented in noise, but not in quiet. Specifically, the neurophysiologic responses from these LP children displayed a different spectral pattern and lacked precision in the neural representation of key stimulus features. Cue enhancement benefited both behavioral and neurophysiological responses. Conclusions: Overall, these findings contribute to our understanding of the preconscious biological processes underlying perception deficits and may assist in the design of effective intervention strategies. q 2001 Elsevier Science Ireland Ltd. All rights reserved.

In order to investigate the precise acoustic features of stop consonants that pose perceptual difficulties for some children with learning problems, discrimination thresholds along two separate synthetic /da-ga/ continua were compared in a group of children with learning problems (LP) and a group of normal children. The continua differed only in the duration of the formant transitions. Results showed that simply lengthening the formant transition duration from 40 to 80 ms did not result in improved discrimination thresholds for the LP group relative to the normal group. Consistent with previous findings, an electrophysiologic response that is known to reflect the brain's representation of a change from one auditory stimulus to another--the mismatch negativity (MMN)--indicated diminished responses in the LP group relative to the normal group to /da/ versus /ga/ when the transition duration was 40 ms. In the lengthened transition duration condition the MMN responses from the LP group were more similar to those from the normal group, and were enhanced relative to the short transition duration condition. These data suggest that extending the duration of the critical portion of the acoustic stimulus can result in enhanced encoding at a preattentive neural level; however, this stimulus manipulation on its own is not a sufficient acoustic enhancement to facilitate increased perceptual discrimination of this place-of-articulation contrast.

An auditory rhyme detection task was employed to examine orthographic code development in 27 reading-disabled (RD) and 27 normally-achieving (NA) children ranging in age from 7-0 to 11-5. The amount of orthographic facilitation (that is, the reduction in response latencies for orthographically similar as opposed to orthographically dissimilar rhyme pairs) was recorded for each subject. Results indicated that RD children exhibit significantly less facilitation overall than NA children and that RD children do not demonstrate comparable orthographic facilitation effects to NA children until they are about two years older than their NA peers. It is concluded that children with a reading disability have a lessened ability to access automatically and make available stored lexical information relating to orthography.

Patients treated for head and neck cancer frequently develop dysphagia. Bolus characteristics are altered during fluoroscopic swallowing studies to observe the impact on swallowing function. The purpose of this study was to determine bolus volume and consistency effects on oropharyngeal swallowing physiology and patient awareness of swallowing difficulty.Twenty-one patients with head and neck cancer were assessed pre-chemoradiation and post-chemoradiation. The Modified Barium Swallow Study (MBSS) was utilized to examine swallow physiology. Each patient provided perceptual ratings of swallowing difficulty after each swallow of varying bolus types.Oral transit times were significantly longer with pudding boluses. There were trends for higher residue percentages as well as perceptual ratings for pudding and cookie boluses. One correlation between perceptual ratings and physiology was significant.Patient awareness of swallowing difficulty and aspects of swallowing physiology vary with bolus consistency. Patient awareness does not correlate with observed changes in swallowing physiology.

Background Children with pervasive developmental disorders (PDD), such as children with autism spectrum disorders (ASD), often show auditory processing deficits related to their overarching language impairment. Auditory training programs such as Fast ForWord Language may potentially alleviate these deficits through training-induced improvements in auditory processing. Methods To assess the impact of auditory training on auditory function in children with ASD, brainstem and cortical responses to speech sounds presented in quiet and noise were collected from five children with ASD who completed Fast ForWord training. Results Relative to six control children with ASD who did not complete Fast ForWord, training-related changes were found in brainstem response timing (three children) and pitch-tracking (one child), and cortical response timing (all five children) after Fast ForWord use. Conclusions These results provide an objective indication of the benefit of training on auditory function for some children with ASD.

Children often have difficulty understanding speech in challenging listening environments. In the absence of peripheral hearing loss, these speech perception difficulties may arise from dysfunction at more central levels in the auditory system, including subcortical structures. We examined brainstem encoding of pitch in a speech syllable in 38 school-age children. In children with poor speech-in-noise perception, we find impaired encoding of the fundamental frequency and the second harmonic, two important cues for pitch perception. Pitch, an important factor in speaker identification, aids the listener in tracking a specific voice from a background of voices. These results suggest that the robustness of subcortical neural encoding of pitch features in time-varying signals is an important factor in determining success with speech perception in noise.

Objective Temporal acuity in the auditory brainstem is correlated with left-dominant patterns of cortical asymmetry for processing rapid speech-sound stimuli. Here we investigate whether a similar relationship exists between brainstem processing of rapid speech components and cortical processing of syllable patterns in speech. Methods We measured brainstem and cortical evoked potentials in response to speech tokens in 23 children. We used established measures of auditory brainstem and cortical activity to examine functional relationships between these structures. Results We found no relationship between brainstem responses to fast acoustic elements of speech and right-dominant cortical processing of syllable patterns. Conclusions Brainstem processing of rapid elements in speech is not functionally related to rightward cortical asymmetry associated with the processing of syllable-rate features in speech. Viewed together with previous evidence linking brainstem timing with leftward cortical asymmetry for faster acoustic features, findings support the existence of distinct mechanisms for encoding rapid vs. slow elements of speech. Significance Results provide a fundamental advance in our knowledge of the segregation of sub-cortical input associated with cortical asymmetries for acoustic rate processing in the human auditory system. Implications of these findings for auditory perception, reading ability and development are discussed.

Children with reading impairments have long been associated with impaired perception for rapidly presented acoustic stimuli and recently have shown deficits for slower features. It is not known whether impairments for low-frequency acoustic features negatively impact processing of speech in reading-impaired individuals. Here we provide neurophysiological evidence that poor readers have impaired representation of the speech envelope, the acoustical cue that provides syllable pattern information in speech. We measured cortical-evoked potentials in response to sentence stimuli and found that good readers indicated consistent right-hemisphere dominance in auditory cortex for all measures of speech envelope representation, including the precision, timing, and magnitude of cortical responses. Poor readers showed abnormal patterns of cerebral asymmetry for all measures of speech envelope representation. Moreover, cortical measures of speech envelope representation predicted up to 41% of the variability in standardized reading scores and 50% in measures of phonological processing across a wide range of abilities. Our findings strongly support a relationship between acoustic-level processing and higher-level language abilities, and are the first to link reading ability with cortical processing of low-frequency acoustic features in the speech signal. Our results also support the hypothesis that asymmetric routing between cerebral hemispheres represents an important mechanism for temporal encoding in the human auditory system, and the need for an expansion of the temporal processing hypothesis for reading disabilities to encompass impairments for a wider range of speech features than previously acknowledged.

The go-no go test requires a subject to emit a simple motor response to one cue while inhibiting the response in the presence of another cue. This test has been effective in demonstrating impulsivity (elevated commission error rate) in children with attention deficit disorder (ADD). In this study, we examined the effects on go-no go test performance of two doses of methylphenidate (0.15 mg/kg and 0.3 mg/kg) administered in double-blind placebo-controlled fashion to children with ADD. Our results indicate that even modest doses of methylphenidate improve the go-no go performance of these children by decreasing their tendency to make impulsive commission errors. Thus the test is sensitive to the effects of methylphenidate and can be used to monitor a response to therapy. (J Child Neurol 1991; 6(Suppl):S126-S129).

Development of the human auditory brainstem is thought to be primarily complete by the age of ∼2 years, such that subsequent sensory plasticity is confined primarily to the cortex. However, recent findings have revealed experience-dependent developmental plasticity in the mammalian auditory brainstem in an animal model. It is not known whether the human system demonstrates similar changes and whether experience with sounds composed of acoustic elements relevant to speech may alter brainstem response characteristics. We recorded brainstem responses evoked by both click and speech syllables in children between the ages of 3 and 12 years. Here, we report a neural response discrepancy in brainstem encoding of these two sounds, observed in 3- to 4-year-old children but not in school-age children. Whereas all children exhibited identical neural activity to a click, 3- to 4-year-old children displayed delayed and less synchronous onset and sustained neural response activity when elicited by speech compared with 5- to 12-year-olds. These results suggest that the human auditory system exhibits developmental plasticity, in both frequency and time domains, for sounds that are composed of acoustic elements relevant to speech. The findings are interpreted within the contexts of stimulus-related differences and experience-dependent plasticity.

Previous demonstrations of "visual" effects in auditory tasks have been largely restricted to orthographic effects with word stimuli. As a result, explanations of such effects have centered around a shared orthography--the similarity of the spelling patterns at the ends of the words. In the present study, these effects were extended to single-letter stimuli. Subjects made rhyming decisions about pairs of letters presented auditorily. Visually similar letter pairs facilitated responses to rhyming pairs and inhibited responses to nonrhyming pairs. The results indicate that visual effects are not restricted to word stimuli and suggest that additive effects of visual similarity and shared orthography may be responsible for these findings.

Children with language-based learning problems often exhibit pronounced speech perception difficulties. Specifically, these children have increased difficulty separating brief sounds occurring in rapid succession (temporal resolution). The purpose of this study was to better understand the consequences of auditory temporal resolution deficits from the perspective of the neural encoding of speech. The findings provide evidence that sensory processes relevant to cognition take place at much earlier levels than traditionally believed. Thresholds from a psychophysical backward masking task were used to divide children into groups with good and poor temporal resolution. Speech-evoked brainstem responses were analyzed across groups to measure the neural integrity of stimulus-time mechanisms. Results suggest that children with poor temporal resolution do not have an overall neural processing deficit, but rather a deficit specific to the encoding of certain acoustic cues in speech. Speech understanding relies on the ability to attach meaning to rapidly fluctuating changes of both the temporal and spectral information found in consonants and vowels. For this to happen properly, the auditory system must first accurately encode these time-varying acoustic cues. Speech perception difficulties that often co-occur in children with poor temporal resolution may originate as a neural encoding deficit in structures as early as the auditory brainstem. Thus, speech-evoked brainstem responses are a biological marker for auditory temporal processing ability.

The left hemisphere of the human cerebral cortex is dominant for processing rapid acoustic stimuli, including speech, and this specialized activity is preceded by processing in the auditory brainstem. It is not known to what extent the integrity of brainstem encoding of speech impacts patterns of asymmetry at cortex. Here, we demonstrate that the precision of temporal encoding of speech in auditory brainstem predicts cerebral asymmetry for speech sounds measured in a group of children spanning a range of language skills. Results provide strong evidence that timing deficits measured at the auditory brainstem negatively impact rapid acoustic processing by specialized structures of cortex, and demonstrate a delicate relationship between cortical activation patterns and the temporal integrity of cortical input.

Children with learning problems often cannot discriminate rapid acoustic changes that occur in speech. In this study of normal children and children with learning problems, impaired behavioral discrimination of a rapid speech change (/dalpha/versus/galpha/) was correlated with diminished magnitude of an electrophysiologic measure that is not dependent on attention or a voluntary response. The ability of children with learning problems to discriminate another rapid speech change (/balpha/versus/walpha/) also was reflected in the neurophysiology. These results indicate that some children's discrimination deficits originate in the auditory pathway before conscious perception and have implications for differential diagnosis and targeted therapeutic strategies for children with learning disabilities and attention disorders.

Fourteen participants (six females, eight males) ranging in age from 7 years 11 months to 18 years 2 months (mean 11y 7mo) with a confirmed diagnosis of spastic cerebral palsy (CP) were included in the study. Participants included those who drooled (CP+, n=14); age- and sex-matched children with spastic CP who were dry to mild and never to infrequent droolers (CP-, n=14) as well as typically developing peers (CTRL, n=14) served as controls. Frequency of swallowing was measured by using simultaneous cervical ausculation and videotaping of the head and neck. Saliva production was measured with the Saxon test, a simple gauze-chewing procedure. In addition, Pediatric Evaluation of Disability Inventory (PEDI), Test of Nonverbal Intelligence-3 (TONI-3), dysarthria severity scale, and Gross Motor Function Classification System (GMFCS) scores were obtained for each participant. Both groups of participants with CP tended to swallow less frequently than typically developing participants and tended to produce less saliva than typically developing controls; however, these differences were not statistically significant. No correlation was found between amount of saliva produced and amount drooled (r=0.245). An analysis of variance (ANOVA) conducted on the PEDI functional skills mean scores indicated significant differences between the three groups (F(2,39)=23.522,p

Language-based learning disorders such as dyslexia affect millions of people, but there is little agreement as to their cause. New evidence from behavioral measures of the ability to hear tones in the presence of background noise indicates that the brains of affected individuals develop more slowly than those of their unaffected counterparts. In addition, it seems that brain changes occurring at ≈10 years of age, presumably associated with puberty, may prematurely halt this slower-than-normal development when improvements would normally continue into adolescence. The combination of these ideas can account for a wide range of previous results, suggesting that delayed brain development, and its interaction with puberty, may be key factors contributing to learning problems.

The auditory brainstem response reflects neural encoding of the acoustic characteristic of a speech syllable with remarkable precision. Some children with learning impairments demonstrate abnormalities in this preconscious measure of neural encoding especially in background noise. This study investigated whether auditory training targeted to remediate perceptually-based learning problems would alter the neural brainstem encoding of the acoustic sound structure of speech in such children. Nine subjects, clinically diagnosed with a language-based learning problem (e.g., dyslexia), worked with auditory perceptual training software. Prior to beginning and within three months after completing the training program, brainstem responses to the syllable /da/ were recorded in quiet and background noise. Subjects underwent additional auditory neurophysiological, perceptual, and cognitive testing. Ten control subjects, who did not participate in any remediation program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Transient and sustained (frequency-following response) components of the brainstem response were evaluated. The primary pathway afferent volley -- neural events occurring earlier than 11 ms after stimulus onset -- did not demonstrate plasticity. However, quiet-to-noise inter-response correlations of the sustained response ( approximately 11-50 ms) increased significantly in the trained children, reflecting improved stimulus encoding precision, whereas control subjects did not exhibit this change. Thus, auditory training can alter the preconscious neural encoding of complex sounds by improving neural synchrony in the auditory brainstem. Additionally, several measures of brainstem response timing were related to changes in cortical physiology, as well as perceptual, academic, and cognitive measures from pre- to post-training.

Objective : This study examined the plasticity of the central auditory pathway and accompanying cognitive changes in children with learning problems. Methods : Children diagnosed with a learning disability and/or attention deficit disorder worked with commercial auditory processing training software for 8 weeks; control groups consisted of normal-learning and learning-impaired children who did not participate in any remedial programs. Auditory brainstem function was evaluated in response to click and speech stimuli in quiet; cortical responses to speech stimuli were obtained in quiet and noise. Academic achievement and cognitive abilities were assessed with standardized measures. Results : Compared to controls, the trained group improved on measures of auditory processing and exhibited changes in cortical responses in quiet and in noise. In quiet, cortical responses reflected an accelerated maturational pattern; in background noise, cortical responses became more resistant to degradation. Brainstem responses did not change with training. Conclusions : Children with learning problems who practiced with auditory training software exhibited plasticity of neural encoding of speech sounds at the cortical, but not subcortical, level of the auditory pathway. This plasticity was accompanied by improvement in behavioral performance. Significance : This study demonstrates that in learning-impaired children working with commercial auditory processing training programs affects both the perception and the cortical representation of sound.

Speech perception depends on the auditory system's ability to extract relevant acoustic features from competing background noise. Despite widespread acknowledgement that noise exacerbates this process, little is known about the neurophysiologic mechanisms underlying the encoding of speech in noise. Moreover, the relative contribution of different brain nuclei to these processes has not been fully established. To address these issues, aggregate neural responses were recorded from within the inferior colliculus, medial geniculate body and over primary auditory cortex of anesthetized guinea pigs to a synthetic vowel-consonant-vowel syllable /ada/ in quiet and in noise. In noise the onset response to the stop consonant /d/ was reduced or eliminated at each level, to the greatest degree in primary auditory cortex. Acoustic cue enhancements characteristic of 'clear' speech (lengthening the stop gap duration and increasing the intensity of the release burst) improved the neurophysiologic representation of the consonant at each level, especially at the cortex. Finally, the neural encoding of the vowel segment was evident at subcortical levels only, and was more resistant to noise than encoding of the dynamic portion of the consonant (release burst and formant transition). This experiment sheds light on which speech-sound elements are poorly represented in noise and demonstrates how acoustic modifications to the speech signal can improve neural responses in a normal auditory system. Implications for understanding neurophysiologic auditory signal processing in children with perceptual impairments and the design of efficient perceptual training strategies are also discussed.

Stimulants are an effective treatment frequently prescribed for attention-deficit-hyperactivity disorder (ADHD), but they commonly are believed to lower the threshold for seizures. Although several studies have revealed that stimulants do not exacerbate well-controlled epilepsy, there is a paucity of data about seizure risk in nonepileptic children treated with stimulants. Two hundred thirty-four children (179 males, 9.1 +/- 3.6 years of age; 55 females, 9.6 +/- 3.9 years of age) with uncomplicated ADHD received electroencephalograms (EEGs) performed in our institution. Thirty-six patients (15.4%) demonstrated epileptiform abnormalities, and 198 (84.6%) demonstrated normal or nonepileptiform EEGs. Rolandic spikes accounted for 40% of the abnormal EEGs and 60% of those with focal abnormalities. Stimulant therapy was elected by 205 of 234 patients (87.6%). Seizures occurred only in the treated group, in one of 175 patients with a normal EEG (incidence 0.6%, 95% confidence intervals 0%-1.7%) and three of 30 treated patients with epileptiform EEGs (incidence 10%, 95% confidence interval 0%-20.7%). Seizures occurred in two of 12 children (16.7%) with rolandic spikes. These data suggest that a normal EEG can be used to assign children with ADHD to a category of minimal risk for seizure. In contrast, an epileptiform EEG in neurologically normal children with ADHD predicts considerable risk for the eventual occurrence of seizure. The risk, however, is not necessarily attributable to stimulant use.

Objectives To evaluate the maturational progression of speech-evoked P1/N1/N2 cortical responses over the life span, determine whether responses are distinctive in clinical populations e-periencing learning problems and elucidate the functional significance of these responses. Design The P1/N1/N2 comple- was measured in 150 normal subjects (5 to 78 yr) and 86 subjects with learning problems (LP) (8 to 15 yr) to a synthetic CV syllable. Analyses included description and comparison of the developmental time course in both groups and evaluation of the relationship between P1/N1/N2 and children’s performance on speech discrimination tasks and standardized learning measures. Results Findings revealed significant changes in waveform morphology, latency and amplitude as a function of age. Maturational patterns in the group of children with learning problems did not differ from the normal group. P1/N1/N2 parameters were significantly correlated with standardized tests of Spelling, Auditory Processing and Listening Comprehension in the LP group. Moreover, there was a predictive relationship between Auditory Processing and N2 latency. Conclusions The P1/N1/N2 comple- changes throughout life from school-age to old age. The developmental sequence throughout the school-age years is similar in normal and LP children. Thus, differences in the rate of P1/N1/N2 latency and amplitude development do not appear to be distinctive in these two populations. The relationship between P1/N1/N2 parameters and standardized measures of learning (particularly between Auditory Processing and N2 latency) provides new information about the role of these responses in hearing and highlights the potential value in characterizing auditory processing deficits.

Observers with dyslexia show a significant increase in backward pattern masking, but the slopes of their psychometric functions do not differ from controls, suggesting a perceptual rather than a cognitive basis for this deficit.

Recent behavioral evidence supports the idea that some individuals with reading and language disorders are impaired in their perception of nonlinguistic auditory and visual information. More sophisticated measurement paradigms and analysis techniques are leading to a clearer understanding of these deficits and to possibilities for their remediation.

This study was designed to investigate the ability of normal young adult volunteers to sensorially identify Newtonian fluids of specified viscosities. Twenty subjects, 10 men and 10 women between the ages of 18 and 29 years participated. Seven stimuli, consisting of combinations of corn syrup and water, with viscosities ranging from 2 to 2,240 centipoise (cP) were prepared and characterized using a coaxial rotational viscometer. Subjects were presented with two anchor stimuli representing the extremes of the range of viscosities as a basis from which the experimental stimuli were judged. The seven experimental stimuli were randomly presented to each subject 10 times. The accuracy with which the subjects identified the viscosity of the fluid was significant at p < 0.01. The pattern of response was not significantly different across subjects nor gender. There were no differences in performance throughout the duration of the study. The repeat presentation of the anchor points did not significantly affect performance. Further research on oral perception of viscosity, and the processes that mediate changes in swallow physiology resulting from changes in viscosity is required.

Language‐based learning problems affect approximately one person in twelve with no other obvious signs of disorder. Many of these individuals have accompanying deficits in nonlinguistic perception. To determine whether age influences the magnitude of these deficits, thresholds on a set of auditory masking tasks were measured in individuals with learning problems and controls ranging in age from 6 years to adult. Performance improved with increasing age in both groups. However, the thresholds of the individuals with learning problems were most similar to those of controls approximately 2–4 years younger on every task, suggesting that the perceptual development of the affected individuals was delayed by a constant amount. Further, on the subset of conditions on which controls reached adult levels of performance after 10 years of age, the improvement of affected individuals halted at 10 years of age, suggesting that puberty may play a critical role in human perceptual development. Taken together, these data ...

This work concerns the relationship between two measures of auditory processing and several measures of cognitive abilities. The discriminabilities of formant transitions in synthesized consonant–vowel syllables were collected from over 100 children aged 7–11. Specifically, the discriminabilities of the F3 onset frequencies were measured in a set of stimuli which ranged perceptually from /dopen aye/ from /gopen aye/. Also, the discriminabilities of the onset transition durations of F1, F2, and F3 were measured in stimuli which ranged perceptually from /bopen aye/ to /wopen aye/. A PEST adaptive tracking paradigm was employed to make these measurements. The average just noticeable difference was 101 Hz for the F3 onset frequencies and 6 ms for the F1, F2, and F3 frequency ramps. A battery of tests of cognitive ability were administered to the same children. The cognitive ability tests revealed a wide range of scores in the subjects tested. A correlational analysis of these data indicated that better onset ...

Although mental practice has often been demonstrated to result in improved learning of a motor skill, theoretical accounts of the reasons for this improvement are lacking. The present experiment examined the role of knowledge of results (KR) in motor skill learning, because KR is believed to be crucial to such learning, yet is lacking during mental practice. Subjects in four conditions (mental practice, physical practice, physical practice without KR, and control), tossed beanbags at a target. Results showed that of the four conditions, mental practice showed the largest performance increment, whereas physical practice showed a decrement attributed to massed practice without adequate rest periods. Results suggest that (a) knowledge of results is not always essential for improved performance; (b) mental practice is most beneficial following sufficient experience with the task; and (c) mental practice may be best suited for a massed practice learning situation.