Listening difficulties in children: Bottom-up and top-down contributions

MRC Institute of Hearing Research, Nottingham NG7 2RD, UK. Electronic address: .
Journal of Communication Disorders (Impact Factor: 1.52). 06/2012; 45(6):411-8. DOI: 10.1016/j.jcomdis.2012.06.006
Source: PubMed

ABSTRACT The brain mechanisms of hearing include large regions of the anterior temporal, prefrontal, and inferior parietal cortex, and an extensive network of descending connections between the cortex and sub-cortical components of what is presently known as the auditory system. One important function of these additional ('top-down') mechanisms for hearing is to modulate the ascending, sensory ('bottom-up') auditory information from the ear. In children, normal, immature hearing during the first decade of life is more strongly influenced by top-down mechanisms than in adulthood. In some children, impaired top-down function presents a significant challenge to their auditory perception, often associated with a range of language and learning difficulties and sometimes called auditory processing disorder. Learning outcomes: Readers will be able to (a) discuss the difference between and integration of auditory information in the ascending, descending, and cortical auditory centres, (b) state alternate interpretations of normal maturation of human hearing in typical children, (c) explain how sensory and cognitive contributions to auditory temporal and spectral processing may be teased apart, (d) discuss how listening difficulties may be assessed in children, and (e) critically assess whether APD is really an auditory problem or may be symptomatic of a broader neurodevelopmental disorder.

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    • "While the ascending, sensory system is largely mature by 2 years of age (Moore, 2002), more central and cognitive functions continue to develop into adolescence and even adulthood (e.g., Bishop et al., 2011; Moore and Linthicum, 2007). It is likely therefore that cognitive limitations will play a greater role than sensory limitations in children's difficulties in performing perceptual tasks (see Moore, 2012). Indeed, Halliday et al. (2008) provided evidence in support of this suggestion by training 6-11 year old children on a frequency discrimination task with a fixed standard frequency. "
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    ABSTRACT: Auditory processing disorder (APD) describes a mixed and poorly understood listening problem characterised by poor speech perception, especially in challenging environments. APD may include an inherited component, and this may be major, but studies reviewed here of children with long-term otitis media with effusion (OME) provide strong evidence for changes in auditory processing acquired through altered experience (deprivation) and brain plasticity. Whether inherited or acquired, it is suggested that APD may be reversed by active learning. Training tunes both bottom-up and top-down neural mechanisms, some that are specific to the trained stimulus and some that reflect more generalised arousal. APD and its treatment therefore provide examples of brain plasticity working either in a negative or in a positive way to modulate listening. LEARNING OUTCOMES: (1) Readers will be able to discuss APD in the context of inheritance and experience. (2) Readers will be able to explain how OME has been shown to alter auditory processing. (3) Readers will be able to list examples of good and bad brain plasticity. (4) Readers will be able to explain what auditory learning is, list some of its properties, and provide examples of its application in therapy for communication disorders.
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