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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.

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.

Duinmeijer I.,Speech and Language Center | Duinmeijer I.,University of Amsterdam | De Jong J.,University of Amsterdam | Scheper A.,Speech and Language Center
International Journal of Language and Communication Disorders | Year: 2012

Background: While narrative tasks have proven to be valid measures for detecting language disorders, measuring communicative skills and predicting future academic performance, research into the comparability of different narrative tasks has shown that outcomes are dependent on the type of task used. Although many of the studies detecting task differences touch upon the fact that tasks place differential demands on cognitive abilities like auditory attention and memory, few studies have related specific narrative tasks to these cognitive abilities. Examining this relation is especially warranted for children with specific language impairment (SLI), who are characterized by language problems, but often have problems in other cognitive domains as well. Methods & Procedures: In the current research, a comparison was made between a story retelling task (The Bus Story) and a story generation task (The Frog Story) in a group of children with SLI (n= 34) and a typically developing group (n= 38) from the same age range. In addition to the two narrative tasks, sustained auditory attention (TEA-Ch) and verbal working memory (WISC digit span and the Dutch version of the CVLT-C word list recall) were measured. Correlations were computed between the narrative, the memory and the attention scores. Outcomes & Results: A group comparison showed that the children with SLI scored significantly worse than the typically developing children on several narrative measures as well as on sustained auditory attention and verbal working memory. A within-subjects comparison of the scores on the two narrative tasks showed a contrast between the tasks on several narrative measures. Furthermore, correlational analyses showed that, on the level of plot structure, the story generation task correlated with sustained auditory attention, while the story retelling task correlated with word list recall. Mean length of utterance (MLU) on the other hand correlated with digit span but not with sustained auditory attention. Conclusions: While children with SLI have problems with narratives in general, their performance is also dependent on the specific elicitation task used for research or diagnostics. Various narrative tasks generate different scores and are differentially correlated to cognitive skills like attention and memory, making the selection of a given task crucial in the clinical setting. © 2012 Royal College of Speech and Language Therapists.

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.

Henkin Y.,Tel Aviv University | Henkin Y.,Speech and Language Center | Yaar-Soffer Y.,Tel Aviv University | Yaar-Soffer Y.,Speech and Language Center | And 4 more authors.
Audiology and Neurotology | Year: 2014

With the growing number of older adults receiving cochlear implants (CI), there is general agreement that substantial benefits can be gained. Nonetheless, variability in speech perception performance is high, and the relative contribution and interactions among peripheral, central-auditory, and cognitive factors are not fully understood. The goal of the present study was to compare auditory-cognitive processing in older-adult CI recipients with that of older normal-hearing (NH) listeners by means of behavioral and electrophysiologic manifestations of a high-load cognitive task. Auditory event-related potentials (AERPs) were recorded from 9 older postlingually deafened adults with CI (age at CI >60) and 10 age-matched listeners with NH, while performing an auditory Stroop task. Participants were required to classify the speaker's gender (male/female) that produced the words 'mother' or 'father' while ignoring the irrelevant congruent or incongruent word meaning. Older CI and NH listeners exhibited comparable reaction time, performance accuracy, and initial sensory-perceptual processing (i.e. N1 potential). Nonetheless, older CI recipients showed substantially prolonged and less efficient perceptual processing (i.e. P3 potential). Congruency effects manifested in longer reaction time (i.e. Stroop effect), execution time, and P3 latency to incongruent versus congruent stimuli in both groups in a similar fashion; however, markedly prolonged P3 and shortened execution time were evident in older CI recipients. Collectively, older adults (CI and NH) employed a combined perceptual and postperceptual conflict processing strategy; nonetheless, the relative allotment of perceptual resources was substantially enhanced to maintain adequate performance in CI recipients. In sum, the recording of AERPs together with the simultaneously obtained behavioral measures during a Stroop task exposed a differential time course of auditory-cognitive processing in older CI recipients that was not manifested in the behavioral end products of processing. These data may have implications regarding clinical evaluation and rehabilitation procedures that should be tailored specifically for this unique group of patients. © 2015 S. Karger AG, Basel.

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.

Barkai G.,Edmond and Lily Safra Childrens Hospital | Barkai G.,Tel Aviv University | Ari-Even Roth D.,Speech and Language Center | Ari-Even Roth D.,Tel Aviv University | And 10 more authors.
Journal of Clinical Virology | Year: 2014

Objectives: To analyze the results of a neonatal universal screen for congenital cytomegalovirus (CMV) using saliva real-time polymerase chain reaction (rt-PCR). Study design: During one year (15/5/2011-15/5/2012), saliva was collected from 9845 infants (97% of 10,137 newborns). Viral DNA was extracted by Magna-Pure LC (Roche) and was tested for the presence of CMV IE and gB genes. Urine culture was collected from positive infants for confirmation. For all infants with congenital CMV maternal data were collected and head ultrasound, blood count, liver enzymes, retinal examination and auditory brainstem response testing were performed. Parents were notified in advance and had the option to avoid screening. The ethical committee approved retrospective analysis of the data. Results: Fifty six infants (0.57%) had a positive saliva assay. Of these, 47 were confirmed by urine rt-PCR and culture, in another one maternal sero-conversion was documented during pregnancy (48 infants). Twenty-eight mothers (28/47, 60%) had primary infection during pregnancy, 14 (30%) had non-primary infection, and no serological data were obtained from five (10%). Four infants (8.5%), two with prenatal diagnosis of CMV and normal fetal brain imaging and two born to mothers sero-positive before pregnancy, exhibited symptoms related to CMV and were offered antivirals. Hearing impairment was diagnosed in two infants (late onset HI in one case). Conclusions: Saliva rt-PCR assay is a feasible and effective means of universal neonatal CMV screening that can detect affected infants who might benefit from treatment and follow-up. The long-term clinical significance of screening and its cost effectiveness are yet to be determined. © 2014 Elsevier B.V.

Muchnik C.,Tel Aviv University | Muchnik C.,Speech and Language Center | Ari-Even Roth D.,Tel Aviv University | Ari-Even Roth D.,Speech and Language Center | And 6 more authors.
Audiology and Neurotology | Year: 2015

Two efferent feedback pathways to the auditory periphery may play a role in monitoring self-vocalization: the middle-ear acoustic reflex (MEAR) and the medial olivocochlear bundle (MOCB) reflex. Since most studies regarding the role of auditory efferent activity during self-vocalization were conducted in animals, human data are scarce. The working premise of the current study was that selective mutism (SM), a rare psychiatric disorder characterized by consistent failure to speak in specific social situations despite the ability to speak normally in other situations, may serve as a human model for studying the potential involvement of auditory efferent activity during self-vocalization. For this purpose, auditory efferent function was assessed in a group of 31 children with SM and compared to that of a group of 31 normally developing control children (mean age 8.9 and 8.8 years, respectively). All children exhibited normal hearing thresholds and type A tympanograms. MEAR and MOCB functions were evaluated by means of acoustic reflex thresholds and decay functions and the suppression of transient-evoked otoacoustic emissions, respectively. Auditory afferent function was tested by means of auditory brainstem responses (ABR). Results indicated a significantly higher proportion of children with abnormal MEAR and MOCB function in the SM group (58.6 and 38%, respectively) compared to controls (9.7 and 8%, respectively). The prevalence of abnormal MEAR and/or MOCB function was significantly higher in the SM group (71%) compared to controls (16%). Intact afferent function manifested in normal absolute and interpeak latencies of ABR components in all children. The finding of aberrant efferent auditory function in a large proportion of children with SM provides further support for the notion that MEAR and MOCB may play a significant role in the process of self-vocalization. © 2013 S. Karger AG, Basel.

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.

PubMed | Safra Childrens Hospital, Ben - Gurion University of the Negev, Speech and Language Center and Bar - Ilan University
Type: Journal Article | Journal: Autism research : official journal of the International Society for Autism Research | Year: 2016

Numerous studies have attempted to identify early physiological abnormalities in infants and toddlers who later develop autism spectrum disorder (ASD). One potential measure of early neurophysiology is the auditory brainstem response (ABR), which has been reported to exhibit prolonged latencies in children with ASD. We examined whether prolonged ABR latencies appear in infancy, before the onset of ASD symptoms, and irrespective of hearing thresholds. To determine how early in development these differences appear, we retrospectively examined clinical ABR recordings of infants who were later diagnosed with ASD. Of the 118 children in the participant pool, 48 were excluded due to elevated ABR thresholds, genetic aberrations, or old testing age, leaving a sample of 70 children: 30 of which were tested at 0-3 months, and 40 were tested at toddlerhood (1.5-3.5 years). In the infant group, the ABR wave-V was significantly prolonged in those who later developed ASD as compared with case-matched controls (n=30). Classification of infants who later developed ASD and case-matched controls using this measure enabled accurate identification of ASD infants with 80% specificity and 70% sensitivity. In the group of toddlers with ASD, absolute and interpeak latencies were prolonged compared to clinical norms. Findings indicate that ABR latencies are significantly prolonged in infants who are later diagnosed with ASD irrespective of their hearing thresholds; suggesting that abnormal responses might be detected soon after birth. Further research is needed to determine if ABR might be a valid marker for ASD risk. Autism Res 2016, 9: 689-695. 2015 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research.

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