CHCS Perspectives Summer/Fall 2013

PERSPECTIVES • SUMMER-FALL 2013 – Page 21 congratulations. This subtest determines the baseline score for the remainder of the test. “When the child does the ‘cat, dog, cow’ test, this is the fastest and the best the child can do, because every child knows these sounds and knows what they go with,” Rowe said. After the baseline question, four subtests assess the auditory con- ditions of consonant discrimination, vowel discrimination, intona- tion patterns, and audio localization (where sound is coming from). In the vowel subtest, children hear the vocalizations “ooh,” “aah,” and “ee” and guess which of three stick-figure faces with different facial expressions is making the sound. The consonant subtest is the same as the vowel subtest except that children hear the vocalizations “ta,” “ma,” and “fa.” During the intonation pattern subtest, children see three stick figures, hear the words “What?” “Oh,” and “Uh-oh” and guess which figure is speaking based on its stance. For the localization subtest, children see three cows, hear one moo, and guess which cow is mooing based on which computer speaker they hear the sound coming from. The test ends with another round of “cat, dog, cow” to make sure the child is still paying attention. “We’re looking at the difference between the six auditory con- ditions mentioned above,” said Dr. Wakefield, the study’s princi- pal investigator. “We then compare the child’s speed and accuracy across the six conditions. If they are able to process them all quickly and correctly, that would suggest they have a very solid foundation of auditory pro- cessing skills.” Rowe said the NNTPT isolates the auditory conditions to see which ones a child struggles with. “We ask, ‘How does the child’s vowel dis- crimination network compare to his ‘cat, dog, cow’ discrimination network? How do conso- nants compare to vowels and the baseline? How do intonation and auditory vocalizations compare?’” she explained. “All these should be easy enough by the time the child is eight years old that all the scores should be equally fast. Sometimes a child can do the ‘cat, dog, cow,’ but they take a long time in the vowel test and make mistakes; and then they do the conso- nants test and they zip through it. Then we can see vowel associations are harder than conso- nant associations.” The baseline subtest also reveals if the child has another type of processing disorder. “The number of children who are coming into our offices with more of a global sensory processing disorder has increased in the recent years. It’s not just auditory. It’s not just visual processing. They’re having difficulty processing information in every sensory do- main,” said Dr. Wakefield. “This test helps us to identify those with more of a global processing deficit by including a baseline test of basic auditory function. If the child is unable to perform the baseline test, it raises additional concerns regarding the child’s attention, fine motor control, or cognition. If that is the case, we can then refer the child to another professional for additional test- ing and treatment.” Although the NNTPT is not meant to replace other auditory processing tests, Dr. Wakefield hopes it will help audiologists diag- nose children younger than seven. Currently, auditory processing test results for children younger than seven have a wide range of what is considered normal due to the variability in children’s lan- guage skills. “Because the NNTPT takes out the language and at- tention demands, it helps us look at auditory processing in a much younger population, or at least that’s our hope with this test meas- ure,” she stated. The study’s first objective is to measure the NNTPT’s reliability. The researchers received a grant from the College of Health Care Sciences for the study in November 2012. Their next step is to receive permission from parents and children at two local elementary schools to conduct the test. Afterward, they will test about 12 or 13 children each week for two months. After this first round of testing, the re- searchers will wait four weeks and administer the test on the same children again. Rowe said this is necessary to see if the NNTPT re- peatedly measures the same thing. “We have to look at if their re- sponses are the same,” Rowe said. “That says it’s a reliable measure.” Study co-investigator Erica Friedland, Au.D., associate professor and chair of the Audiology Department, hopes the study will find the NNTPT reliable because it can be important to giving children with auditory processing problems better therapy. Children can work with a variety of therapists depending on whether they have auditory, visual, or other issues. “If this is another test to help de- termine where and what they’re having difficulty learning, we can use it to plan therapy more effectively,” Dr. Friedland said. If the NNTPT is deemed reliable, the researchers will collect normative data to test its validity, which Dr. Wakefield defined as the question of whether it gives a good picture of auditory process- ing. Dr. Friedland said collecting normative data will involve writing another proposal to test a higher number of children of various ages. The second project’s scope will be greater because collecting normative data means sampling a larger population to test if chil- dren of the same age and development have the same range of scores. “We’ll use the test on typical children of different ages, grouped by age, and see the variance in each group,” she explained. Rowe said the NNTPT will be integrated into the rest of the NeuroNet program if the normative data shows it is effective. She hopes the test will become a tool for therapists to help struggling children correct problems and accurately evaluate their abilities to manage auditory temporal processing.