The Association Between Peripheral and Central Auditory Abilities and Protein Energy Malnutrition in Children

Abstract

Protein-energy malnutrition (PEM) affects physical and cognitive development, making it a major health concern in developing nations. Earlier studies have shown that many sensory processes are affected in individuals with PEM. In children, it can impair the development of the auditory system due to nutrient deficiencies, compromised brain and immune function, and increased susceptibility to hearing loss and auditory processing disorders. However, the relationship between PEM and auditory abilities has not been established. Therefore, this study aimed to understand the relationship between PEM and children's peripheral hearing sensitivity and central auditory processing abilities.108 children aged 7-14 were divided into a control group (Group 1) and a PEM group (Group 2). Various auditory tests were conducted, including pure tone audiometry, speech audiometry, and immittance evaluation for peripheral auditory abilities. Additionally, a battery of tests was used to assess central auditory processing skills, including the binaural fusion test, speech perception in noise test in Kannada, dichotic CV test, gap detection test, sinusoidal amplitude modulation test, and various tests of auditory working memory. The results revealed that although PEM did not significantly affect peripheral hearing sensitivity, there were significant differences between the two groups in central auditory processing abilities. Children with PEM demonstrated poorer performance in tasks assessing binaural interaction, auditory closure, and auditory working memory than the control group. Spearman’s correlation showed that BMI impacted various central auditory tests. The findings suggest malnutrition may impact higher-order auditory processing skills rather than basic auditory sensitivity. Impaired nerve connections, deficient myelination of the auditory pathway, and compromised attention and working memory may collectively contribute to auditory deficits in malnourished children.