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Eindhoven, Netherlands

Gordon K.,University of Toronto | Henkin Y.,Speech and Language Center | Henkin Y.,Tel Aviv University | Kral A.,Institute of Audio Neuro Technology | And 2 more authors.
Pediatrics | Year: 2015

Deafness affects ∼2 in 1000 children and is one of the most common congenital impairments. Permanent hearing loss can be treated by fitting hearing aids. More severe to profound deafness is an indication for cochlear implantation. Although newborn hearing screening programs have increased the identification of asymmetric hearing loss, parents and caregivers of children with single-sided deafness are often hesitant to pursue therapy for the deaf ear. Delayed intervention has consequences for recovery of hearing. It has long been reported that asymmetric hearing loss/single-sided deafness compromises speech and language development and educational outcomes in children. Recent studies in animal models of deafness and in children consistently show evidence of an ¡°aural preference syndrome¡± in which singlesided deafness in early childhood reorganizes the developing auditory pathways toward the hearing ear, with weaker central representation of the deaf ear. Delayed therapy consequently compromises benefit for the deaf ear, with slow rates of improvement measured over time. Therefore, asymmetric hearing needs early identification and intervention. Providing early effective stimulation in both ears through appropriate fitting of auditory prostheses, including hearing aids and cochlear implants, within a sensitive period in development has a cardinal role for securing the function of the impaired ear and for restoring binaural/spatial hearing. The impacts of asymmetric hearing loss on the developing auditory system and on spoken language development have often been underestimated. Thus, the traditional minimalist approach to clinical management aimed at 1 functional ear should be modified on the basis of current evidence. © 2015 by the American Academy of Pediatrics.


Reznik D.,Tel Aviv University | Henkin Y.,Tel Aviv University | Henkin Y.,Speech and Language Center | Levy O.,Tel Aviv University | Mukamel R.,Tel Aviv University
PLoS ONE | Year: 2015

Performing actions with sensory consequences modifies physiological and behavioral responses relative to otherwise identical sensory input perceived in a passive manner. It is assumed that such modifications occur through an efference copy sent from motor cortex to sensory regions during performance of voluntary actions. In the auditory domain most behavioral studies report attenuated perceived loudness of self-generated auditory action-consequences. However, several recent behavioral and physiological studies report enhanced responses to such consequences. Here we manipulated the intensity of self-generated and externally-generated sounds and examined the type of perceptual modification (enhancement vs. attenuation) reported by healthy human subjects. We found that when the intensity of self-generated sounds was low, perceived loudness is enhanced. Conversely, when the intensity of self-generated sounds was high, perceived loudness is attenuated. These results might reconcile some of the apparent discrepancies in the reported literature and suggest that efference copies can adapt perception according to the differential sensory context of voluntary actions. © 2015 Reznik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Henkin Y.,Tel Aviv University | Swead R.T.,Speech and Language Center | Roth D.A.-E.,Tel Aviv University | Kishon-Rabin L.,Tel Aviv University | And 4 more authors.
Laryngoscope | Year: 2014

Objectives/Hypothesis To compare speech perception performance with right versus left cochlear implants (CIs) in children with bilateral CIs implanted simultaneously. Study Design Prospective case series of patients undergoing simultaneous bilateral cochlear implantation. Methods Speech perception performance was tested in 10, right-handed children who received bilateral CIs simultaneously between 11 and 36 months (mean, 21 months), had at least 18 months of bilateral CI use, and were 5.3 years of age during testing. All children exhibited bilateral symmetrical severe-to-profound hearing loss prior to implantation and did not benefit from hearing aids. Speech perception performance was evaluated with the right CI and the left CI by means of an open-set monosyllabic word test in quiet presented at 45 dB HL in a sound field. Results All children exhibited higher performance with the right CI compared to the left CI. Group mean performance with the right CI was 66.5% compared to 52% with the left CI (P=.002), yielding a 14.5% difference. With increasing duration of bilateral CI use and age at evaluation, the right-left difference increased (r=0.72, P=.019 and r=0.74, P=.014, respectively). Conclusions Current preliminary data indicate that children with bilateral CIs implanted simultaneously exhibit a significant right ear advantage for speech. Similarly to reports on normal-hearing children, right ear preference for speech increased with increasing age and auditory-linguistic experience. Thus, simultaneous bilateral cochlear implantation may lead to normal development of auditory pathways and may be an important contributor to the superior auditory, language, and communication skills reported in children with bilateral versus unilateral CIs. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.


Reznik D.,Tel Aviv University | Henkin Y.,Tel Aviv University | Henkin Y.,Speech and Language Center | Schadel N.,Tel Aviv University | Mukamel R.,Tel Aviv University
Nature Communications | Year: 2014

Performing actions with auditory consequences modulates the response in auditory cortex to otherwise identical stimuli passively heard. Such modulation has been suggested to occur through a corollary discharge sent from the motor cortex during voluntary actions. However, the relationship between the effector used to generate the sound, type of modulation and changes in perceptual sensitivity are unclear. Here we use functional magnetic resonance imaging on healthy subjects and demonstrate bilateral enhancement in the auditory cortex to self-generated versus externally generated sounds. Furthermore, we find that this enhancement is stronger when the sound-producing hand is contralateral to the auditory cortex. At the behavioural level, binaural hearing thresholds are lower for self-generated sounds and monaural thresholds are lower for sounds triggered by the hand ipsilateral to the stimulated ear. Together with functional connectivity analysis, our results suggest that a corollary discharge sent from active motor cortex enhances activity in the auditory cortex and increases perceptual sensitivity in a lateralized manner. © 2014 Macmillan Publishers Limited. All rights reserved.


Cuperus J.,Speech and Language Center | Vugs B.,Speech and Language Center | Scheper A.,Speech and Language Center | Hendriks M.,Radboud University Nijmegen | Hendriks M.,Kempenhaeghe Center for Epileptology
International Journal of Developmental Disabilities | Year: 2014

Background: There is growing evidence that linguistic and non-linguistic factors may contribute to the problems associated with specific language impairment (SLI). One factor that has been implicated is executive functioning (EF). Most studies investigating EF in children with SLI use performance based tasks. Significant group differences in children with SLI are reported on the following components of EF: inhibition, working memory, planning and fluency, although not on the 'shifting' component. Correlations between performance based measurements of EF and ratings of everyday EF behaviours are often low. It is possible that standardised tests are not sufficiently sensitive to the multidimensional nature of EF. Therefore it is suggested that information on EF should be collected in different contexts and from different sources using behavioural ratings, like the Behaviour Rating Inventory of Executive Function (BRIEF) for children. Methods and procedures: A clinical sample of 237 school aged children, aged 5-12 years, (157 boys, 80 girls) with SLI participated in this study. Behavioural and cognitive measures of EF were administered: the BRIEF-questionnaire, assessing everyday EF behaviour in a home and school setting and two EF tasks: Digit span (WISC-III-NL) and Creature Counting (TEA-Ch). Outcomes and results: Compared to the normative sample the prevalence of EF problems in school in children with SLI is much higher than in the normal population. Teachers reported significantly more problems on almost all EF domains (i.e. Inhibition, Shifting, Emotional control, Initiate, Working memory, Plan/organise, and Monitor), except organisation of materials. Working memory and Initiate are the most impaired, since more than one third of the children had scores in the clinical range on these scales. Compared to the normative sample parents scored significantly more working memory problems. MANOVA-analyses showed developmental and gender differences on EF behaviour in school. Overall, older children had less problems in EF behaviours than younger children and boys showed more problems than girls. Like others we found low correlations between behavioural and cognitive measures (r=0.20). Conclusions: School aged children with SLI show substantial impairments in everyday EF behaviour in a classroom setting. Almost one third of the children scored in the clinical range on the Metacognition Index. Our findings replicate low correlations between performance based and behavioural based measures on EF. These findings indicate the importance of expanding EF assessment with behavioural measures in clinical practice for children with SLI. © The British Society for Developmental Disabilities 2014.

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