Effectiveness of Computer Based Auditory Training in Children with Central Auditory Processing Disorders-Evidence from Electrophysiological Study

Abstract

The children with central auditory processing disorders (CAPD) finds difficulty in following oral instruction and understanding of speech in presence of background noise; ask for repetition, even exhibit poor academic performance on listening tasks. The present study was aimed to evaluate the effectiveness of computer based auditory training (CBAT) in children with CAPD. The objectives included were (1) Comparison between pre-training, post-training, after one week and one month cessation of training, based on outcomes of psychophysical tests which mainly assesses central auditory function (SPIN, PDT, GDT, & TMTF) in children with CAPD. (2) Comparison between pre and post-training outcomes of electrophysiological tests (speech evoked ABR and LLR) in children with CAPD. To accomplish the above objective the children across the school in Mysuru city were screened using SCAN and STAP for children with CAPD. Twenty eight children with CAPD were selected based on detail diagnostic CAPD tests randomly for the CBAT using inclusion criteria. These 28 children with CAPD were further sub-grouped into 4 groups randomly based on different stimuli used for the CBAT. Group-I included 7 children, provided CBAT using speech based stimuli without Earobics. Group-II included 7 children; they were provided speech based stimuli with Earobics. Group-III included 7children were provided non-speech stimuli. Group-IV included 7children were provided non-speech stimuli with Earobics. The psychophysical tests (Speech in noise, Gap detection test, Pitch discrimination test, and temporal modulation transfer function) were performed before CBAT, immediately after CBAT, 1 week after CBAT, and 1 month after CBAT. The electrophysiological tests (Speech evoked ABR and LLR) were carried out before and immediately after the CBAT. The computer based auditory training provided for 12 sessions, each session for 25-30 minutes for a total duration of 5 weeks. The result showed that there was a significant improvement in all psychophysical tests immediately after the CBAT as well as retention was noticed even after 1 week and 1 month cessation of computer based training. There are studies supports that the psychophysical tests that the sensitivity of these tests is good in predicting even small changes in the auditory processing skills and also that any type of auditory training can bring a changes in the psychophysical tests. Electrophysiological tests such as Sp-ABR showed no significant difference, this could be due to the conviction that plasticity at the level of auditory brainstem is poor. However, electrophysiological test like long latency response shows neuron changes at cortical levels and this could be observed that Sp-LLR latency parameters showed some amount of significant changes (improvement) after CBAT. To conclude the CBAT is one of the effective approaches for providing auditory training for children with CAPD.