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Quantitative Assessment of Cortical Auditory-tactile Processing in Children with Disabilities
Published on: January 29, 2014
Preliminary observations on the development of auditory sensitivity in infants with Down syndrome
L A Werner1, L R Mancl, R C Folsom
1University of Washington, Department of Speech and Hearing Sciences, Seattle, USA.
Insights
Hearing loss is common in Down syndrome. This study found that an observer-based method effectively assessed hearing sensitivity in infants with Down syndrome, showing similar developmental patterns but poorer thresholds than typically developing infants.
Area of Science:
- Audiology
- Developmental Pediatrics
- Genetics
Background:
- Hearing loss is a common comorbidity in Down syndrome.
- Early auditory development in infants with Down syndrome is not well understood.
Purpose of the Study:
- To evaluate an observer-based procedure for assessing behavioral hearing sensitivity in infants with Down syndrome.
- To gather preliminary data on the early trajectory of auditory sensitivity development in this population.
Main Methods:
- An observer-based procedure was used to measure behavioral sensitivity in 16 infants with Down syndrome.
- Longitudinal testing was conducted on 10 infants from 2 to 12 months of age.
- Auditory brainstem response and tympanometry screenings were performed; 4000 Hz tone detection thresholds were obtained.
Main Results:
- The observer-based procedure yielded usable thresholds in 15 of 16 infants.
- Infants with Down syndrome showed improved auditory sensitivity with age, similar to typically developing infants.
- Thresholds were elevated (10-25 dB higher) compared to typically developing infants, with shallower psychometric functions suggesting inattentiveness.
Conclusions:
- An observer-based method is feasible for assessing hearing in infants with Down syndrome as young as 2 months.
- Both sensory and non-sensory factors likely contribute to elevated hearing thresholds.
- The developmental course of auditory sensitivity appears qualitatively similar to that of typically developing infants.
Objective:
Hearing loss commonly is associated with Down syndrome, but little is known about the development of auditory sensitivity in individuals with Down syndrome. This study had two objectives: 1) to determine whether an observer-based procedure can be used to assess the behavioral sensitivity of infants with Down syndrome, and 2) to provide preliminary information about the early course of hearing development among infants with Down syndrome.
Design:
Behavioral measures of sensitivity were made in 16 infants with Down syndrome using an observer-based procedure. Ten of the infants were followed longitudinally between 2 and 12 mo of age. All infants passed a screening auditory brain stem response at 20 dB nHL during the study and completed screening tympanometry at each test session. The infants detected a 4000 Hz tone at levels ranging from 25 to 50 dB SPL; psychometric functions and thresholds for the tone were obtained.
Results:
Infants with Down syndrome completed 80% of the test sessions they began, a rate similar to that seen in normally developing infants in the same type of study. Performance improved with increasing stimulus level, as one would expect, and thresholds were obtained from 15 of 16 infants for at least one age. The performance of infants with Down syndrome generally improved with age. The sensitivity of 2- to 3-mo-olds was poorer than that of older infants, but little if any improvement in sensitivity occurred between 4 and 12 mo. This pattern is similar to that seen in normally developing infants. Thresholds of infants with Down syndrome were 10 to 25 dB higher than those reported for normally developing infants. The psychometric functions of infants with Down syndrome were shallower than the psychometric functions of normally developing infants, and the slope of the psychometric functions did not change with age. Infants with Down syndrome achieved only 75 to 80% correct at any of the levels tested, 5 to 10% poorer than reported for other infants. These characteristics of the psychometric functions of the infants with Down syndrome suggest that they are inattentive during testing more often than are normally developing infants.
Conclusions:
An observer-based procedure can be used to obtain reasonable thresholds from infants with Down syndrome who are as young as 2 mo of age. Both sensory and nonsensory factors could contribute to the threshold elevation seen in infants with Down syndrome. At least on preliminary examination, the course of auditory sensitivity development of infants with Down syndrome is qualitatively similar to that seen in normally developing infants.
