1. Frank E. Musiek, Ph.D., Jennifer Shinn, M.S., and Christine Hare, M. A.

2.  Auditory Plasticity : the alteration of nerve cells to better conform to immediate environmental influences, with this alteration of often associated with behavioral change.  Auditory Training (AT) : The training of the patient with a hearing loss in the optimum use of residual hearing. (Intro to Audiology)  Auditory Processing Disorder (APD) : Difficulty in the development of language and other communication skills associated with disorders of the auditory centers in the brain. (Introduction to Audiology)

3.  Extensive studies on rodents, monkeys, cats, and birds have given researchers evidence that support s the plasticity of the brain.  Studies focused on the brain stem and the auditory cortex.

4.  Deprivation – hearing loss in some manner.  High stimulation (tasking of the auditory system) Ex. AT

5.  Developmental plasticity  Compensatory plasticity  Learning-related plasticity

6.  Simple auditory tasks vs. Complex tasks

7.  Reserve neurons  New connections

8.  Synaptic connections  Neuronal location

9.  Two main areas of clinical experience: Hearing aids Cochlear Implants EX. Patient with bilateral sensorineural hearing loss wearing only one hearing aid. Over time will have decreased speech recognition in non amplified ear. While amplified ear remains constant or gets better. Evidence of cortical reorganization.

10.  Success of implants is evidence of neural plasticity.  Success rate is better before the age of 6; however, studies have shown that neural plasticity continues throughout life and age should not be a criterion for implantation.

11.  Behavioral speech perception tests  Functional imaging techniques  Auditory evoked potentials  Obligatory  Discriminative

12.  Diagnosing and managing APD begins with an audiologist.  Formal training requires use of special equipment used by an AUD in a clinic or lab. The intensive training targets specific stimuli to foster improved processing in a graded manner. Ex. Computer software. To hard or to easy = unaffective.  Because concerns also involve language, learning, reading and auditory memory it is essential that SLP’s and Educational Psychologist be involved in assessment and treatment as well.

13.  Foundation of auditory processing Training temporal processing  Computer games  Patterns  Attention to stress and prosody

14.  Refers to the brain's ability to organize and make sense of language sounds.  Children with auditory discrimination difficulties might have trouble understanding and developing language skills. Often, these children cannot differentiate between similar sounds, or they are unable to recognize language in certain situations.  One treatment strategy is called Earobics – a computer program that trains phonemic segmentation and auditory discrimination of vowels, consonants and blends. Also helps with auditory memory, attention and listening.

15.  The ability to combine sounds that are presented orally to make words (parentpals.com)  Vocabulary technique based on research of how children learn words.

16.  Binaural integration is the ability simultaneously to process two different messages, when one is presented to each ear  Binaural separation is the ability to process an auditory message delivered to one ear while ignoring a different message delivered to the other ear.  Dichotic training uses stimuli such as words, CVs, numbers, phrases, sentences and complex acoustic stimuli to improve dichotic listening. The integration task the listener responds to the stimuli in both ears. In the Separation task the patient ignores one ear and responds to stimulus in the other ear.

17.  Remaining attentive to auditory stimulation over a sustained period of time. -Listening & Learning -Diagnostic test outcomes -AT training

18.  Treatment to develop the child’s ability to listen for general concepts rather than trying to hear, process,and recall large amounts of detail.  Read paragraph - sketch main idea on paper – repeat process till all paragraphs are sketched-child reviews sketches and verbally relate the concepts for each paragraph.

19.  Two critical aspects of AT: Attention Motivation It is the job of the therapist to be caring, supportive and innovative to help the patient stay motivated and maintain the attention needed for success.

20.  http://www.parentpals.com/gossamer/pages/Detailed /890.html http://www.parentpals.com/gossamer/pages/Detailed /890.html  Martin, N. F. & Clark, G. J. Introduction to Audiology.  Musiek F, Shinn J, & Hare, C. Plasticity, Auditory Training, and Auditory Processing Disorders. Seminars in Hearing 200; 23:263-272.