EFFECTIVENESS OF FORMAL AUDITORY TRAINING IN ADULTS WITH AUDITORY PROCESSING DISORDER

The present study is justified by the complaints of adults regarding auditory processing and the scarcity of investigations involving central auditory processing in the adult population. The aim of this study was to compare the performance of adults with auditory processing disorder on behavioral tests performed prior to and following formal auditory training to determine the efficacy of such training.  INTRODUCTION


INTRODUCTION
][3] In adulthood, the impact of this disorder is evident in social and professional realms.Conventional language therapy does not generally include the expectations of the patient.Thus, formal auditory ABSTRACT Purpose: to compare the performance of adults with auditory processing disorder in behavioral tests before and after formal auditory training, in order to verify the effectiveness of this approach.Methods: this is a quantitative retrospective study for which we selected 18 individuals with auditory processing disorders evidenced by the behavioral assessment, aged between 16 and 38 years old.All subjects underwent a formal auditory training program conducted in eight sessions of 45 minutes each, twice a week.Sessions were organized in ascending order of complexity of the listening skills srech as, auditory closure, figure-ground for sentences, words, syllables and sounds and nonverbal temporal processing of sounds (analysis of the intensity, duration and frequency).For statistical purposes the results of the SSW test SSI (ICM) and Duration and frequency pattern recognitive obtained before and after auditory training, considering the ear and sex variables.Results: there were no statistically significant differences between the right and left ears.Both men and women when analyzed separately showed better results in post-training.These differences were statistically significant in for duration and frequency pattern tests, for men and women.In SSW improvement in male and SSI R / S -15 females, respectively.In addition, all subjects reported better attention and better communicative performance after auditory training.Conclusion: the formal auditory training improves listening skills figure -ground for verbal sounds and temporal processing measured by behavioral tests in adults diagnosed with auditory processing disorders.

KEYWORDS: Hearing; Auditory Perception; Hearing Disorders; Neuronal Plasticity
Patient histories were taken and all subjects underwent a basic hearing evaluation, an auditory processing behavioral evaluation and formal auditory training.Each subject served as his/her own control based on the stability/changes demonstrated on the auditory processing behavioral tests. 11The auditory processing behavioral evaluation tests were administered before and after auditory training.
Auditory training was organized in eight 45-minute sessions held twice a week and involved the training of the following listening skills: temporal ordination, auditory closure, figure-ground for verbal and nonverbal sound on tasks of monotic and dichotic listening.The right and left ears were trained separately. 12Figure 1   This study received approval from the Ethics Committee of the university under process number 2123/08.

Statistical analysis involved the nonparametric
Wilcoxon test for the comparison of paired data (each subject serving as his/her own control).The confidence interval test was used to determine range of reliability in the mean results.The level of significance was set to 5% (p < 0.05).
performed considering both ears together.Figures 2 and 3 display the results of the pre-training and post-training hearing behavior tests for the female and male genders, respectively.

RESULTS
No significant differences were found between the right and left ears.Thus, the analysis was   In the analysis of the overall sample, an improvement was found on the SSW following auditory training.However, as the pre-training scores were within the range of normality, this improvement did not achieve statistical significance.Similar findings are described in the literature consulted. 822,24 These findings demonstrate the effectiveness of auditory training.Previous studies report the stability of auditory processing behavior tests. 11,21,24,25uestions remain regarding who patients will use the skills learned in formal auditory training in activities of daily living and whether such skills will be maintained in the long term.However, studies have demonstrated that the demands of the environment itself lead to the maintenance of learned listening skills. 3

CONCLUSION
The findings of the present study demonstrate that the auditory training program was effective with regard to the hearing rehabilitation of adults with auditory processing disorder.Improvements were found in the listening skills of figure-ground for verbal sounds (sentences and words) and the temporal ordination of sounds (duration and frequency).Following training, the participants reported no longer having difficulties conversing in unfavorable environments.Thus, such short-term training is a viable option for these patients, offering improved access to auditory information.

DISCUSSION
The concept of auditory training dates back to the 6 th century, but was preferentially indicated for patients with severe to profound hearing impairment and was used in schools for the deaf or in rehabilitation clinics.At the time, this type of training was not used in the clinical practice of hearing and speech therapists due to the lack of scientific research on the subject.Recently, however, new studies have demonstrated promising results in children and individuals who wear hearing aids. 11,13n the present study, four hearing behavior tests were selected to study the effectiveness of formal auditory training on adults with normal hearing but with abnormal results on at least one of these hearing behavior tests (DPT, FPT, SSW and SSI N/S-15). 14Both genders demonstrated improvements following auditory training (Figures 2 and  3).Statistically significant differences were found on the DPT and FPT in both genders, whereas a significant improvement on the SSW only occurred among the males and a significant improvement on the SSI only occurred among the females.][17][18][19][20][21][22] Neural plasticity is the key factor involved in this improvement.6][17][18][19][20][21][22][23][24][25][26] Greater improvements are achieved in younger patients.7,28 Moreover, the improvement is not limited to statistical analyses, as demonstrated by the reports of patients and family members regarding academic, professional and social performance. 26valiado sem as próteses auditivas.Revista Cefac.2010;12(5):733-40.9. Baran

Figure 2 -Figure 3 -
Figure 2 -Results of FPT, DPT, SSW and SSI before and after training among females

Table 2
displays the magnitude of the improvements in performance of the overall sample.occurred on the DPT, FPT and SSI (S/N-15) and a non-significant improvement occurred on the SSW.