Development and evaluation of the LiSN & learn auditory training software for deficit-specific remediation of binaural processing deficits in children: preliminary findings.
Abstract
BACKGROUND
The LiSN & Learn auditory training software was developed specifically to improve binaural processing skills in children with
suspected central auditory processing disorder who were diagnosed as having a spatial processing disorder (SPD). SPD is defined
here as a condition whereby individuals are deficient in their ability to use binaural cues to selectively attend to sounds
arriving from one direction while simultaneously suppressing sounds arriving from another. As a result, children with SPD
have difficulty understanding speech in noisy environments, such as in the classroom.
PURPOSE
To develop and evaluate the LiSN & Learn auditory training software for children diagnosed with the Listening in Spatialized
Noise-Sentences Test (LiSN-S) as having an SPD. The LiSN-S is an adaptive speech-in-noise test designed to differentially
diagnose spatial and pitch-processing deficits in children with suspected central auditory processing disorder.
STUDY SAMPLE
Participants were nine children (aged between 6 yr, 9 mo, and 11 yr, 4 mo) who performed outside normal limits on the LiSN-S.
RESEARCH DESIGN
In a pre-post study of treatment outcomes, participants trained on the LiSN & Learn for 15 min per day for 12 weeks. Participants
acted as their own control. Participants were assessed on the LiSN-S, as well as tests of attention and memory and a self-report
questionnaire of listening ability. Performance on all tasks was reassessed after 3 mo where no further training occurred.
INTERVENTION
The LiSN & Learn produces a three-dimensional auditory environment under headphones on the user's home computer. The child's
task was to identify a word from a target sentence presented in background noise. A weighted up-down adaptive procedure was
used to adjust the signal level of the target based on the participant's response.
RESULTS
On average, speech reception thresholds on the LiSN & Learn improved by 10 dB over the course of training. As hypothesized,
there were significant improvements in posttraining performance on the LiSN-S conditions where the target and distracter stimuli
are spatially separated and which specifically evaluate binaural processing ability (p ranging from <.003 to .0001, η2 ranging
from 0.694 to 0.873). In contrast, there was no improvement on the LiSN-S control conditions where the target and distracter
stimuli emanate from the same direction (p ranging from .07 to .86, η2 ranging from 0.362 to 0.004). Significant improvements
were found posttraining on measures of memory, on one measure of attention, and on self-reported ratings of listening ability.
There were no significant differences between post- and 3 mo posttraining scores on any of the assessment tools.
CONCLUSIONS
The initial LiSN & Learn study has shown that children as young as 6 yr of age are able to complete the training (although
some coaxing was needed in a minority of cases). Both parents and children have reported benefits from the training, and feedback
from the trial has resulted in extra features being added to the software. In order to further evaluate the efficacy of LiSN
& Learn to remediate binaural processing deficits in children a clinical trial is currently under way utilizing a randomized
blinded control group design.
Links
Authors
Institution
National Acoustic Laboratories, New South wales, Australia. Sharon.Cameron@nal.gov.au
Source
Journal of the American Academy of Audiology 22:10 pg 678-96MeSH
AttentionAuditory Perceptual Disorders
Calibration
Child
Computer-Assisted Instruction
Humans
Memory
Noise
Patient Education as Topic
Pilot Projects
Pitch Perception
Questionnaires
Rehabilitation of Hearing Impaired
Semantics
Software Design
Sound Localization
Speech-Language Pathology
Pub Type(s)
Clinical TrialJournal Article
Research Support, Non-U.S. Gov't
Language
eng
PubMed ID
22212767
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