4/24/18 CAPD AND ANSD: A BASIC OVERVIEW. Presenters: Objectives for Today. IECC Session B16 May 3, 2018

Transcription

1 CAPD AND ANSD: A BASIC OVERVIEW IECC Session B16 May 3, 2018 Presenters: Nancy Hatfield, Ph.D. Early Childhood Consultant, WSDS/Deaf-Blind Project Emma Packard, M.Ed./M.A. TVI, O&M Specialist Consultant, WSDS/Deaf-Blind Project Objectives for Today 1. Define the terms Central Auditory Processing Disorder (CAPD) and Auditory Neuropathy Spectrum Disorder (ANSD) in lay terms. 2. Present a framework for considering a child s risk factors, behaviors, and audiologic test results for ANSD and CAPD. 3. Describe some do no harm strategies to support speech/language acquisition and learning in children at risk for one of these conditions. 3 1

2 And, why are WE here? (1/2) #1 Lily 4 And, why are WE here? (2/2) #2 Jenny 5 1. LAY DEFINITIONS OF CAPD AND ANSD 6 2

3 Overview of Hearing 7 Definition of Auditory Neuropathy/Dys-synchrony A type of sensorineural hearing loss that hinders clear transmission of sound signals to brain; the signals are often distorted. 8 Where ANSD Occurs

4 4/24/18 ANSD: Deeper Dive 10 ANSD: Some Factoids ANSD is much more complicated than we originally thought. 11 Simulation of Auditory Neuropathy/Dyssynchrony How would this type of hearing loss affect development of spoken language and learning? 12 4

5 4/24/18 Definition of Central Auditory Processing Disorder (CAPD) A problem not with actually hearing sounds, but with processing in the brain the sounds we hear. 13 Where CAPD Occurs CAPD: Some Factoids Affects approximately 2 3% of children. 15 5

6 Simulation of Central Auditory Processing Disorder (CAPD) How might this type of disorder affect a child s development of spoken language, reading, and academic achievement? A FRAMEWORK FOR DIFFERENTIATING CAPD AND ANSD: A. RISK FACTORS B. BEHAVIORS C. AUDIOLOGIC TESTS 17 2.a Risk Factors: ANSD and CAPD ANSD CAPD 18 6

7 Syndromes Associated with ANSD Charcot-Marie-Tooth Disease Leber s Hereditary Optic Neuropathy Fredreich s Ataxia Refsum s Disease Mitochondrial Disease 19 2.b.1 Behavioral Characteristics ANSD (1 of 2) Infants often will pass newborn hearing screening, if only OAEs are used b.1 Behavioral Characteristics ANSD (2 of 2) Hearing may fluctuate. 21 7

8 In Washington s 62 birthing hospitals, newborn hearing screening looks like this: 35 (56%) use AABR for initial screen 18 (29%) use OAE for initial hearing screen 9 (14.5%) use OAE and/or AABR* *Some have NICUs. The OAE is for wellbaby nursery; AABR is for NICU b.2 Behavioral Characteristics CAPD (1 of 2) Difficulty understanding speech in presence of competing background noise* * * * 23 2.b.2 Behavioral Characteristics CAPD (2 of 2) 24 8

9 2.c - Audiologic Tests ANSD CAPD Tympanogram Normal (or not) Normal (or not) Middle ear muscle reflexes Otoacoustic emissions (OAE) Auditory brainstem responses (ABR) Pure-tone thresholds Word recognition (quiet) Word recognition (noise) Abnormal or absent Present or absent (vary over time) Abnormal or absent Normal to severe/ profound Excellent to poor Poor Present and normal Present Normal Normal Excellent Fair to poor 25 Test Battery for CAPD Includes at least one or two dichotic listening tests SCAN-C Test includes four tests of AP including filtered words, auditory figure ground, competing words, and competing sentences 26 A word about CVI (cortical visual impairment) Any child with a diagnosis of CVI and concomitant speech/language delays should be assumed to have cerebral hearing impairment (or) auditory processing disorder... ~ Gordon Dutton 27 9

10 3. STRATEGIES TO SUPPORT SPEECH/ LANGUAGE ACQUISITION AND LEARNING WHEN YOU SUSPECT CAPD OR ANSD 28 3.a Strategies to Support Children ANSD (1 of 2) There is great heterogeneity; individualized monitoring and observation required for each child 29 3.a Strategies to Support Children ANSD (2 of 2) Hearing aids help about half of children with ANSD, at least in quiet settings 30 10

11 3.b Strategies to Support Children CAPD (1 of 2) Manage the noise in child s environment 31 3.b Strategies to Support Children CAPD (2 of 2) 32 References/Resources See Attachment for more complete list with hyperlinks. Central Auditory Processing Disorder Bellis, Teri J. (n.d.). Understanding Auditory Processing Disorders in Children. Retrieved from Chermak, G.D., Musiek, F.E., & Weihing, J. (2017, May). Beyond controversies: The science behind central auditory processing disorder. Hearing Review, 24(5): Retrieved from: Heymann, L. K. (2010). The sound of hope: Recognizing, coping with, and treating your child s auditory processing disorder. New York, NY: Ballantine Books

12 References Auditory Neuropathy Spectrum Disorder Berlin, C.I. et al. (2010). Multi-site diagnosis and management of 260 patients with Auditory Neuropathy/Dys-synchrony (Auditory Neuropathy Spectrum Disorder). International Journal of Audiology, 49: Clarin, G.P. (2015). Auditory neuropathy spectrum disorder. In A resource guide for early hearing detection and intervention. The NCHAM ebook (Chapter 8). Retrieved from: Chapter8AuditoryNeuropathy2015.pdf Teagle, Holly F. B. (2013, January). Cochlear implants for children with auditory neuropathy spectrum disorder: What are we learning? AudiologyOnline, Article # Retrieved from 34 Contact Us! Emma Packard ebpackard@msn.com (206) Nancy Hatfield Nancy.S.Hatfield@gmail.com (800)