Browsing by Author "Nickisch, Andreas"

Current notions of "hearing impairment," as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as "Auditory Processing Disorder" (APD) or "Central Auditory Processing Disorder" is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus.

Zusammenfassung Hintergrund Ob sich die an unauffälligen Kindern beschriebenen Reifungsprozesse des zentralen Hörsystems auch an Kindern mit auditiven Verarbeitungs- und Wahrnehmungsstörungen (AVWS) im Grundschulalter nachweisen lassen, sollte an 2 Schülerjahrgängen (1. und 4. Klasse) im Kontrollgruppenvergleich untersucht werden. Material und Methoden In die Auswertung gingen 7 Testergebnisse von 82 Erstklässlern (40 mit AVWS; 42 unauffällige Kinder) und 65 Viertklässlern (35 mit AVWS; 30 unauffällige Kinder) ein. Es wurde eine ANOVA mit dem Gesamtsummenwert aus folgenden 7 Untersuchungen sowie anschließend eine MANOVA mit den Einzeltestergebnissen durchgeführt: Göttinger Sprachaudiometrie II im Störgeräusch; dichotisches Wortpaarverstehen (Uttenweiler-Test); Phonemdifferenzierung, Phonemidentifikation, Phonemanalyse (Subtests aus Heidelberger Lautdifferenzierungstest); Zahlenfolgen-Gedächtnis (Subtest aus psycholinguistischem Entwicklungstest); Mottier-Test. Ergebnisse Die ANOVA zeigte signifikante Haupteffekte von „Schuljahr“ (p < 0,001; η² = 0,418) und „Gruppe“ (p < 0,001; η² = 0,690), jedoch keine Interaktionseffekte zwischen beiden. Das Ergebnis der MANOVA war ähnlich bzgl. der o. g. Haupteffekte; nur für 2 Tests (Phonemidentifikation, Phonemanalyse) wurde die Interaktion der Faktoren Schuljahr und Gruppe mit jeweils geringen Effektstärken von 3 bzw. 6 % statistisch signifikant. Diskussion Gemäß dieser Querschnittsstudie scheint der Unterschied zwischen den beiden Gruppen unabhängig vom Schuljahr zu sein. Fazit Im Grundschulalter gibt es nicht nur für unauffällige Kinder, sondern auch für solche mit AVWS Hinweise auf eine Reifung des zentralen Hörsystems.

The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (Cls) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young Cl users and hearing variables, such as age at implantation, or functional gain of Cl. The survey included 140 adolescents with Cl (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the Cl group, 35 adolescents were identified as "risk cases" due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions "Self," "Parent," and "Teacher." The Cl group showed significantly more "Peer Problems" than the NH group. When the Cl group was split into a "risk-group" (35 "risk cases" and 11 non-classifiable persons) and a "non-risk group" (n = 94), increased peer problems were perceived in both Cl subgroups by adolescents themselves. However, no further differences between the Cl non-risk group and the NH group were observed in any rater. The Cl risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the Cl non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the Cl risk-group compared to the Cl non-risk group and the NH group. Adolescents with Cl, who were able to understand speech in noise had significantly less difficulties compared to constricted Cl users. Parents, teachers, and clinicians should be aware that Cl users with additionally special needs may have mental health problems. However, peer problems were also experienced by Cl adolescents without additional handicaps.