Health  Vol.9 No.6 , June 2017
Formal Auditory Training with Individuals after Traumatic Brain Injury
Purpose: Establishing the effects of a formal auditory training program on individuals, after a traumatic brain injury by means of behavioral and electrophysiological tests. Study Design: Longitudinal study. Setting: Study conducted at the electrophysiology clinic of the Federal University of São Paulo. Patients: Nine individuals with normal hearing, 20 to 37 years old, who were exposed to severe traumatic brain injury (score of 3 - 8 on the Glasgow Coma Scale upon hospital admission), 6 - 24 months earlier (11 months on average) and had imaging tests showing diffuse axonal injury with or without associated focal lesion. Intervention(s): subjected to a formal auditory training program in an acoustic booth involving eight 45-minute sessions aiming at training the auditory temporal order judgment (frequency and duration of sounds), auditory closure, and figure-ground separation skills for verbal and nonverbal sounds in monotic and dichotic listening tasks. The sessions and activities, in each session, were organized in increasing order of complexity to challenge the auditory system. In order to establish the efficacy of the auditory training, all participants were subjected to behavioral and electrophysiological assessments of the auditory processing, before and after the formal auditory training. Results: On the electrophysiological assessment, the absolute latencies of waves III and V, and of interpeak interval I-V decreased after the auditory training. However, the P300 did not exhibit a significant difference in either the latency or the amplitude parameters. Regarding the behavioral assessment of the auditory processing, it was verified that adequacy of the auditory figure-ground skills for verbal sounds, and the temporal order judging skills. Conclusions: individuals with diffuse axonal injury following a severe traumatic brain injury exhibited an improvement of central auditory processing after formal auditory training, as manifested on electrophysiological and behavioral assessments.
Cite this paper: Marangoni, A. , Suriano, Í. , Buriti, A. and Gil, D. (2017) Formal Auditory Training with Individuals after Traumatic Brain Injury. Health, 9, 975-986. doi: 10.4236/health.2017.96070.

[1]   Braga, F.M. and Ferraz, F.A.P. (1995) Traumatic Brain Injury (TBI). In: Prado, F.C., Ramos J. and Valle, J.R., Eds., Therapeutic Updates. Practical Manual of Diagnosis and Treatment, Livraria Editora Artes Médicas Ltda, Sao Paulo, 728-730.

[2]   Musiek, F.E. and Chermak, G. (2008) Testing and Treating (C) APD in Head Injury Patients. The Hearing Journal, 61, 36-38.

[3]   Bergemalm, P.O. and Lyxell, B. (2005) Appearances are Deceptive: Long-Term Cognitive and Central Auditory Sequelae from Closed Head Injury. International Journal of Audiology, 44, 39-49.

[4]   Lendrem, W. and Lincon, N.B. (1985) Spontaneous Recovery of Language in Patients with Aphasia between 4 and 34 Weeks after Stroke. Neurosurgery & Psychiatry, 48, 743-748.

[5]   Nudo, J. (2011) Neural Bases of Recovery after Brain Injury. Journal of Communication Disorder, 44, 515-520.

[6]   Musiek, F.E. and Berge, B.E. (1998) A Neuroscience View of Auditory Training/Stimulation and Central Auditory Processing Disorders. In: Masters, M.G., Stecker, N.A. and Katz, J., Eds., Central Auditory Processing Disorders—Mostly Management, Allyn and Bacon, Boston, 15-32.

[7]   Jirsa, R.E. (1992) The Clinical Utility of the P3 AERP in Children with Auditory Processing Disorders. Journal of Speech and Hearing Research, 35, 903-912.

[8]   Tremblay, K., Kraus, N. and McGee, T. (1998) The Time Course of Auditory Perceptual Learning: Neurophysiological Changes during Speech-Sound Training. NeuroReport, 9, 3557-3560.

[9]   Kraus, N. (1999) Speech-Sound Perceptual Learning. The Hearing Journal, 52, 64-66.

[10]   Tremblay, K.L. and Kraus, N. (2002) Auditory Training Induces Asymmetrical Changes in Cortical Neural Activity. Journal of Speech, Language, and Hearing Research, 45, 564-572.

[11]   Musiek, F.E., Shinn, J. and Hare, C. (2002) Plasticity, Auditory Training and Auditory Processing Disorders. Seminars in Hearing, 23, 264-275.

[12]   Cone-Wesson, B. and Wunderlich, J. (2003) Auditory Evoked Potentials from the Cortex: Audiology Applications. Current Opinion on Otolaryngology and Head and Neck Surgery, 11, 372-377.

[13]   Hayes, E.A., Warrier, C.M., Nicol, T.G., Zecker, S.G. and Kraus, N. (2003) Neural Plasticity Following Auditory Training with Learning Problems. Clinical Neurophysiology, 114, 673-684.

[14]   Russo, N.M., Nicol, T.G., Zecker, S.G., Ilayes, E.A. and Kraus, N. (2005) Auditory Training Improves Neural Timing in the Human Brainstem. Behavioral Brain Research, 156, 95-103.

[15]   Alonso, R. and Schochat, E. (2009) The Efficacy of Formal Auditory Training in Children with (Central) Auditory Processing Disorder: Behavioral and Electrophysiological Evaluation. Brazilian Journal of Otorhinolaryngology, 75, 726-732.

[16]   Vieira, H.S. and Reis, A.C.M.B. (2009) Assessment of the Effectiveness of Auditory Training in a Group of Children with Auditory Processing Disorder. Trabalho de conclusao de curso.

[17]   Gil, D. And Iorio, M.C.M. (2010) Formal Auditory Training in Adult Hearing Aid Users. Clinics, 65, 165-174.

[18]   Musiek, F.E. and Schochat, E. (1998) Auditory Training and Central Auditory Processing Disorders—a Case Study. Seminars in Hearing, 19, 357-365.

[19]   Zalcman, T.E. and Schochat, E. (2007) Formal Auditory Training Efficacy in Individuals with Auditory Processing Disorder. Revista da Sociedade Brasileira de Fonoaudiologia, 12, 310-314.

[20]   Pinheiro, F.H. and Capellini, S.A. (2010) Auditory Training in Students with Learning Disabilities. Pró-Fono Revista de Atualizacao Científica, 22, 49-54.

[21]   Ziliotto, Z.N. and Pereira, L.D. (2007) Auditory Stimulation in Acoustic Booth: Case Report. In: Pereira, L.D., Azevedo, M.F., Machado, L.P., Ziliotto, K.N., Ed., Auditory Processing: Speech Therapy. A Rehabilitation Approach, Lovise, Sao Paulo.

[22]   Cruz, A.C.A., Andrade, A.N. and Gil, D. (2013) The Efficacy of Formal Auditory Training in Adults with Central Auditory Processing Disorder. Revista CEFAC, 15, 1427-1434.

[23]   Song, J.H., Skoe, E., Banai, K. and Kraus, N. (2012) Training to Improve Hearing Speech in Noise: Biological Mechanisms. Cerebral Cortex, 22, 1180-1190.

[24]   Anderson, S., White-Schwoch, T., Choi, H.J. and Kraus, N. (2014) Partial Maintenance of Auditory-Based Cognitive Training Benefits in Older Adults. Neuropsychologia, 62, 286-296.

[25]   Pereira, L.D. and Dias, K.Z. (2009) Speech Therapy in Auditory Processing Disorders Focused on Auditory-Verbal Training. In: Cesar, A.M., Maksud, S.S., Fundamentals and Practices in Speech Therapy, Revinte, Rio de Janeiro, 137-148.

[26]   Dias, K.Z. and Gil, D. (2011) Formal Auditory Training in Auditory Processing Disorders. In: Bevilacqua, MC, Martinez MA, Balen SA, et al, Treatise on Audiology, Santos Editora, Santos, 828-844.

[27]   Musiek, F.E. (2004) The DIID: A New Treatment for APD. The Hearing Journal, 57, 50.

[28]   Santos, C.B., Figueiredo, E.G. and Teixeira, M.J. (2011) Cognitive Rehabilitation and Head Injury. Arquivos Brasileiros de Neurocirurgia, 30, 51-54.

[29]   Teasdale, G. and Mathew, P. (1996) Mechanisms of Cerebral Concussion, Contusion and Other Effects of Head Injury. In: Youmans, J.R., Ed., Neurological Surgery, W.B. Saunders Co., New York, 1533-1546.

[30]   Fagerholm, E.D., Hellyer, P.J., Scott, G., Leech, R. and Sharp, D.J. (2015) Disconnection of Network Hubs and Cognitive Impairment after Traumatic Brain Injury. Brain, 138, 1696-1709.

[31]   Wright, M.J., Wong, A.L., Obermeit, L.C., Woo, E., Schmitter-Edgecombe, M., and Fuster, J.M. (2014) Memory for Performed and Observed Activities Following Traumatic Brain Injury. Journal of Clinical and Experimental Neuropsychology, 36, 268-277.

[32]   Musiek, F.E. and Berge, B.E. (1998) How Electrophysiologic Tests of Central Auditory Processing Influence Management. In: Bess, F., Ed., Children with Hearing Impairment, Bill Wilkerson Center Press, Nashville, 145-162.

[33]   Song, J.H., Nicola, T. and Kraus, N. (2011) Test-Retest Reliability of the Speech-Evoked Auditory Brainstem Response in Young Adults. Clinical Neurophysiology, 122, 346-355.

[34]   Tremblay, K., Kraus, N., McGee, T., Ponton, C. and Otis, B. (2001) Central Auditory Plasticity: Changes in N1-P2 Complex after Speech-Sound Training. Ear and Hear, 22, 79-90.

[35]   Souza, L.C.A., Piza, M.R.T., Alvarenga, K.F. and Cóser, P.L. (2016) Electrophysiology of Hearing and Otoacoustic Emissions: Principles and Clinical Applications. 3rd Edition, Editora Booktoy, Sao Paulo, 95-109.

[36]   Merzenich, M.M., Jenkins, W.M., Johnston, P., Schreiner, C., Miller, S.L. and Tallal, P. (1996) Temporal Processing Deficits of Language-Impaired Children Ameliorated by Training. Science, 271, 77-80.