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Background: Children with Auditory Processing Disorder (APD) often have poor auditory processing skills in the presence of normal peripheral hearing. These children have worse listening-in-noise skills compared to typically developing peers, while other commonly reported symptoms include poor attention and distractibility. One of the management strategies for children with APD is the use of Remote Microphone Hearing Aids (RMHAs), which can help improve the signal-to-noise ratio in the child's ears. The aim of this randomised controlled trial was to examine whether RMHAs improved classroom listening in children with APD, and to further test their effects on children's listening-in-noise and attention skills following a 6-month intervention., Methods: Twenty-six children diagnosed with APD, aged 7-12, in primary mainstream education, were randomised into the intervention ( N = 13) and control group ( N = 13). The primary outcome measure was the Listening Inventory for Education - Revised questionnaire, completed by children to assess their listening using RMHAs under several acoustically challenging situations in the classroom. Secondary outcome measures included the Listening in Spatialised Noise - Sentences test, assessing speech-in-noise perception and spatial listening, and the Test of Everyday Attention for Children, assessing different types of attention skills. Tests were conducted in unaided conditions. Mixed analysis of variance was used to analyse the data. The clinical trial was registered at clinicaltrials.gov (unique identifier: NCT02353091)., Results: The questionnaire scores of self-reported listening skills in the classroom significantly improved in the intervention group after 3, MD = 7.31, SE = 2.113, p = 0.014, and after 6 months, M = 5.00, SE = 1.468, p = 0.016. The behavioural measures of listening-in-noise and attention did not significantly change., Conclusion: Use of RMHAs improves classroom listening, evidenced by the results of the questionnaire analysis, while a 6-month use did not have adverse effects on unaided spatial listening or attention skills., (Copyright © 2020 Stavrinos, Iliadou, Pavlou and Bamiou.)

Auditory processing disorder (APD) is a specific deficit in the processing of auditory information along the central auditory nervous system. It is characterized mainly by deficits in speech in noise recognition. APD children may also present with deficits in processing of auditory rhythm. Rhythmic neural entrainment is commonly present in perception of both speech and music, while auditory rhythmic priming of speech in noise has been known to enhance recognition in typical children. Here, we test the hypothesis that the effect of rhythmic priming is compromised in APD children, and further assessed for correlations with verbal and non-verbal auditory processing and cognition. Forty APD children and 33 neurotypical ones were assessed through (a) WRRC, a test measuring the effects of rhythmic priming on speech in noise recognition, (b) a battery of auditory processing tests, commonly used in APD diagnosis, and (c) two cognitive tests, assessing working memory and auditory attention respectively. Findings revealed that (a) the effect of rhythmic priming on speech in noise recognition is absent in APD children, (b) it is linked to non-verbal auditory processing, and (c) it is only weakly dependent on cognition. We discuss these findings in light of Dynamic Attention Theory, neural entrainment and neural oscillations and suggest that these functions may be compromised in APD children. Further research is needed (a) to explore the nature of the mechanics of rhythmic priming on speech in noise perception and why the effect is absent in APD children, (b) which other mechanisms related to both rhythm and language are also affected in this population, and (c) whether music/rhythm training can restore deficits in rhythm effects., (Copyright © 2020 Sidiras, Iliadou, Nimatoudis and Bamiou.)

Auditory processing disorder (APD) is defined as a specific deficit in the processing of auditory information along the central auditory nervous system, including bottom-up and top-down neural connectivity. Even though music comprises a big part of audition, testing music perception in APD population has not yet gained wide attention in research. This work tests the hypothesis that deficits in rhythm perception occur in a group of subjects with APD. The primary focus of this study is to measure perception of a simple auditory rhythm, i.e., short isochronous sequences of beats, in APD children and to compare their performance to age-matched normal controls. The secondary question is to study the relationship between cognition and auditory processing of rhythm perception. We tested 39 APD children and 25 control children aged between 6 and 12 years via (a) clinical APD tests, including a monaural speech in noise test, (b) isochrony task, a test measuring the detection of small deviations from perfect isochrony in a isochronous beats sequence, and (c) two cognitive tests (auditory memory and auditory attention). APD children scored worse in isochrony task compared to the age-matched control group. In the APD group, neither measure of cognition (attention nor memory) correlated with performance in isochrony task. Left (but not right) speech in noise performance correlated with performance in isochrony task. In the control group a large correlation ( r = -0.701, p = 0.001) was observed between isochrony task and attention, but not with memory. The results demonstrate a deficit in the perception of regularly timed sequences in APD that is relevant to the perception of speech in noise, a ubiquitous complaint in this condition. Our results suggest (a) the existence of a non-attention related rhythm perception deficit in APD children and (b) differential effects of attention on task performance in normal vs. APD children. The potential beneficial use of music/rhythm training for rehabilitation purposes in APD children would need to be explored.

The relation between rhythm and language has been investigated over the last decades, with evidence that these share overlapping perceptual mechanisms emerging from several different strands of research. The dynamic Attention Theory posits that neural entrainment to musical rhythm results in synchronized oscillations in attention, enhancing perception of other events occurring at the same rate. In this study, this prediction was tested in 10 year-old children by means of a psychoacoustic speech recognition in babble paradigm. It was hypothesized that rhythm effects evoked via a short isochronous sequence of beats would provide optimal word recognition in babble when beats and word are in sync. We compared speech recognition in babble performance in the presence of isochronous and in sync vs. non-isochronous or out of sync sequence of beats. Results showed that (a) word recognition was the best when rhythm and word were in sync, and (b) the effect was not uniform across syllables and gender of subjects. Our results suggest that pure tone beats affect speech recognition at early levels of sensory or phonemic processing.