Saturday, February 19, 2011

Communication- Auditory Processing in children with Autism

8        Communication: Consider communication with respect to the functional occupation of social interactions with others during a play based activity. Describe the auditory processing challenges in children with autism that you see clinically.  Describe the methods & findings of a research article on auditory processing.  What is 1 treatment strategy given the findings?

We have heard through different discussions and readings, that ASD population may have auditory Processing Challenges.

AP issues can have great impact on functional communication during play based activities for children with autism. I found an interesting article on this very same topic but first let me go over what I see in the clinical setting.

Anna is a verbal 8 year old child with autism on my caseload who is “Lost”-unable to excel during group interaction or activity, and yet when seen individually, her tolerance, attitude and performance on specific understanding questions is much better.

The more I think of it, the more I remember using visual information presentation during our one to one sessions, and she performs better. Is it the background noise that’s cut off? Is it the proximity to another adult and ability to lip read, basically using visual cues instead of “auditory” that helps her make sense of things?

Anna always appeared shy and avoided joining fun play groups, until one day during the class Valentines’ dance party, when I trialed my ipod Nano with her with children’s songs! Anna was dancing with quite elaborate moves, right in the middle of the dance floor, not at all shy, looking rather confident. Is it the pitch changes and rhythm of music she is comfortable with rather than the decoding of speech sounds of people around?

In my search for answer to “What is exactly different in Anna’s auditory processing?” I found this great article in the journal of developmental science that compared group of children with ASD to group of normally developing “control group” with similar IQ.

I particularly like the methodology used since it seemed very simple. At first they tested each subject on visual Pairs of shape and color differences, the child had to look at the two cards with similar or different “color” or “shape” and say “Different”, or “similar”. This was just to get them acclimated to understanding how to answer.

After achieving 80% accuracy on the visual “pair- difference” recognition, now they were then given the “Pair of sounds”, and asked if they could tell if the sound bite is similar or different. “Music-Music”, “Speech-Speech”, and “Music-Speech” were the different categories.

What the study found is to me ALARMING! ASD children had a hard time differentiating between “Music” and “speech” sound, or speech –speech sounds! The control group children not on the spectrum were pretty comparable to ASD on “Music-music” category, but significantly better in recognizing differences on “Music-Speech” category.

Interestingly ASD children seem to be able to catch the “difference” in the PITCH changes, within “Music-Music” sound bites, demonstrating evidence that ASD children hold similar perceptual processing ability as the control group.

Could it be then this focus on detail of difference between pitch, is probably what is keeping them away from identifying the overall difference of the two sound bites? (Complementing the Weak Central Coherence theory findings.)

Now looking back, I can see that the reason ANNA avoided group was not because she was shy, rather she was overwhelmed with multiple verbal interactions, unable to categorize witch ones to take notice of. Anna looked lost because she could not process what some one said to her, given her difficulty filtering the background verbal input.

She enjoyed the Music pitch changes because she could differentiate, and did not HAVE to even make meaning out of it, just had to coordinate spatial body movements resonating with the music.

As a treatment strategy, I would recommend presenting same information in visual form, if possible or giving one SHORT verbal instruction at a time, speaking in slow speed.

Would love to blog more on “Communication and autism” topic, look for the next weeks posting if you are interested!


The reference for the article is:

Anna Jarvinen-P., Heaton, P., Evidence for reduced domain specificity in auditory processing in autism. Developmental science, 10:6 (2007), pp786-793, UK.


6 comments:

  1. HI, Deepali - Thanks for this post. I would be curious to learn more about the methodology of this study... How did they present the sounds? did they remove all "visual" cues? And, if so, then was something about the pitch of the music more "identifiable" because the kids "pair" the meaning fo speech sounds with visual of mouth moving, and without it they couldn't recognize the speech as speech sound?
    It is interesting to consider if these children rely on the visual cues, is the pitch of the music something more tangible or "acute" to register?
    If you could please edit your post and put the reference in, that would be great.
    thanks!
    Amy

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  2. Thanks for giving the example of Anna, along with information from the article. It helps me to comprehend the article more when there is an example to link it to.
    It is hard to summarize a topic in a few paragraphs. I know when I did my first blog, I kept thinking of other directions/topics to begin to discuss, but then thought "I need to stop somewhere!" Looking forward to more info.

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  3. The article refers to the study/experiment being carried out in a quiet room, and subject was provided with only the two sound bites through “headphones”. In the music –music category, ASD children did close to the performance of the TD (typically developing) children in terms of “Pitch sensitivity” or recognizing the “different pitch”, between two sound bites, but they did WORSE than TD children when the pair to be compared was “Speech-speech”, or “speech-music”. So, in a sense, the presence of words appeared to be making an impact on recognition of difference in pitch.

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  4. Deepali,
    That sounds like an interesting article. I have had a student who followed my directions better when I "sang" them as opposed to just saying them.
    Jen

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  5. Deepali,
    Interesting, I have had children stop and look at me when I either sing or hum a rhythm (could be my singing that scares them. They appear more ready to take a verbal and demonstrative direction.

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  6. Deepali,
    That is so interesting about Anna and her response to music. I am also surprised to hear that children with an ASD have a hard time distinguishing between music and speech sounds. Did Anna respond differently to music with words compared to music without words?

    I remember reading an article about how the brain processes music with words (lyrics) compared to music that was purely instrumental. This article was in relation to the new trend for teenagers listening to I pods while doing homework. According to the article even if music with lyrics is background noise our brain tries to process and make sense of the words. In order to better focus on studying they recommended instrumental music with no words/lyrics.

    I found one piece of research by Daniela Sammler of the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany. She did a study on how the brain process music and words (Lyrics) She concluded that the brain first deals with music and lyrics together. Then, after passing through the mid-STS more complex processing kicks in, such as understanding what lyrics mean, and the two are treated separately. "The more they are processed, the more they are separated," she says. See link http://www.newscientist.com/data/images/ns/cms/dn18626/dn18626-1_536.jpg

    I recently discovered that one little girl on my case load that was very distractible and could not follow simple directions responded much more consistently when I sang the directions. I have no idea why this worked and I certainly cannot sing well but she loved it and was more responsive!
    Catherine

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