The research and development leading to the IMAP-test battery and IHR-STAR was funded by the Medical Research Council (MRC) and a grant from the Oticon Foundation. Thanks go to Lorna Halliday, Sally Hind and Alison Riley, who provided help in the planning stages of the work and Sonja Ratib and team for testing the IMAP test battery during the large population-based study or auditory processing. IHR technical and support staff provided invaluable assistance with the project - we particularly acknowledge the contributions of Tim Folkard, Victor Chilekwa, Dave Bullock and John Chambers.

This protocol is aimed at both researchers and clinicians. It briefly outlines: (i) the IMAP ('IHR multicentre study of auditory processing') test battery which is based primarily on the use of nonverbal AP tests, (ii) information on the factors introduced into the battery to ensure a successful child-centric approach, and (iii) a step-by-step guide to describe the test procedure to be used with children aged six years or older.
1. IMAP test battery
The IMAP battery provides a comprehensive auditory and cognitive assessment which can be administered in about one hour. It comprises a total of 10 tests: five AP tests, based on non-linguistic materials, a speech-in-noise test, a sustained attention test, designed to assess attention in both the auditory and visual modalities, and four cognitive tasks that assess reading, verbal short-term memory, working memory and nonverbal intelligence (NVIQ). Brief descriptions of these tests are provided in Appendix A.
During testing, auditory stimuli are delivered through comfortable, high quality headphones (e.g. Sennheiser HD25) and the child responds via a colorful, three button box (Figure 1). The IMAP test battery is presented via the IHR-STAR (IHR System for Testing Auditory Responses) platform test. This software platform comprises a suite of programs for generating stimuli, controlling the order of presentation of AP and cognitive tests, and ensuring that test protocols are adhered to. 
 <img src="/files/ftp_upload/2139/2139fig1.jpg" alt="Figure 1" /> 
 Figure 1. A child being tested on the IMAP test-battery. The key features to notice are the colorful button box, the use of headphones through which sounds are presented, and the child-friendly images on the computer-screen. 
 

Two 'tracks' are presented for each AP test. The tracks each comprise 20 trials, where a trial is a sequence of three stimuli (inter-stimulus interval 400 ms): two identical 'standard' stimuli and a different, 'target' stimulus. The location of the target stimulus is varied randomly within the sequence and child is required to identify the 'odd-one-out'. This is called a three-interval, three-alternate forced-choice (3I-3AFC) oddball response paradigm (Figure 2). 
 
 <img src="/files/ftp_upload/2139/2139fig2.jpg" alt="Figure 2" /> 
 Figure 2. Illustration of a trial in a test of frequency discrimination. There are three intervals i.e., three tones. Two tones are the same (1000 Hz) while the third one is different (1500 Hz). This is the target. 
 

The standard tone in IMAP is a 1000 Hz for all tests. The parameters for the 'target' tone depend on the AP-test and details are provided in Table 1. During testing the relevant parameters for the 'target' are varied according to the child's previous response using an 'adaptive', staircase method which is designed to converge quickly on an estimate of threshold (i.e., minimum detectable difference). See Table 1 for a summary of the different rules for step-size changes for the AP-tests.
Stimulus and response data are stored electronically for later extraction and analysis.
<table border="1">
 <tbody>
 <tr>
 <td>Test</td>
 <td>Track rules (step size, staircase)</td>
 <td>Target frequency; duration; initial presentation level</td>
 <td>Masking noise type; centre frequency; width; level; duration</td>
 </tr>
 <tr>
 <td>Backward masking 
 (0 ms gap)</td>
 <td>1. 15 dB, 1-down 1-up 
 2. 10 dB, 1-down 1-up 
 3. 5 dB, 3-down 1-up 
 Linear scale</td>
 <td>1000 Hz; 20 ms (10 ms cosine-ramp); 
 
 90 dB SPL</td>
 <td>Bandpass; 1000 Hz; 800 Hz; 30 dB/Hz; 300 ms</td>
 </tr>
 <tr>
 <td>Backward masking 
 (50 ms gap)</td>
 <td>As above</td>
 <td>1000 Hz; 20 ms (10 ms cosine- ramp) 
 75 dB SPL</td>
 <td>As above</td>
 </tr>
 <tr>
 <td>Simultaneous masking (no-notch)</td>
 <td>As above</td>
 <td>1000 Hz; 20 ms (10 ms cosine-ramp) 
 95 dB SPL</td>
 <td>As above</td>
 </tr>
 <tr>
 <td>Simultaneous masking 
 ( notch)</td>
 <td>As above</td>
 <td>1000 Hz; 20 ms (10 ms cosine-ramp) 
 90 dB SPL</td>
 <td>Bandstop; 1000 Hz; 1200 Hz (400 Hz spectral notch); 30 dB/Hz ; 300 ms</td>
 </tr>
 <tr>
 <td>Frequency discrimination</td>
 <td>1. 2 &#948;Hz, 1-down 1-up 
 2. 2 &#948;Hz 1-down 1-up 
 3. 1.41&#948;Hz 3-down 1-up 
 Log scale</td>
 <td>S = 1000 Hz 
 T = 1500 Hz (&#948; = 50%) 
 200 ms; 70 dB SPL</td>
 <td>Not applicable</td>
 </tr>
 <tr>
 <td>VCV speech-in-noise</td>
 <td>1. 10 dB, 1-down 1-up 
 2. 5 dB, 1-down 1-up 
 3. 3 dB, 3-down 1-up</td>
 <td>T = consonant in VCV e.g., aGa 
 80 dBA</td>
 <td>ICRA-5 (male; one-speaker); 60 dBA</td>
 </tr>
 </tbody>
</table>
Table 1. Stimulus parameters and adaptive rules for the AP and VCV tests. S = standard; T = target.
2. Child-friendly Approach
Specific elements internal and external to the software are used to enhance and maximize the child's engagement with the protocol.
Communication. It is essential to establish a good rapport between the tester and the child. This includes using age-appropriate language, presenting the test session as a series of 'games to play' rather than 'tests to perform', talking directly to the child (not just to the parent) and using appropriate child-friendly body language. A standardized dialogue has been developed for each test (see Appendix B), which ensures instructions are clear and age appropriate. The tester must also check that the child has fully understood the instructions.
Test environment. Testing should be conducted in a quiet room with no auditory or visual distractions. This minimizes masking effects of background noise, and avoids confounds due to the child's attention being drawn away from the tests. Ideally, only the child and tester should be present during testing.
Familiarization. A familiarization phase is incorporated into the protocol. It is performed prior to testing, and includes presentation of easy-to-identify suprathreshold stimuli alongside impossible-to-detect stimuli. This ensures the oddball paradigm and forced-choice test formats are understood. The tester can then provide further clarification if necessary. Familiarization is further facilitated by beginning each test with easily identifiable target stimuli so the child enjoys an immediate sense of success.
Lapses of attention. An incorrect response early in the track due to a temporary lapse in attention can result in an artificially elevated threshold. To minimize this, the track is automatically abandoned when an incorrect response occurs within the first two trials. Tracks can be restarted a maximum of three times before testing is aborted for that particular test.
Minimization of boredom. AP track durations are designed to be short (20 trials) and each take between 1.5 and 2 minutes to complete. Listening and cognitive tests are interleaved within the test sequence to maintain a sense of novelty for the child. Finally, the 'forced-choice' method allows the child to work at his/her own pace.
Engagement. The tests are presented as fun, computer games to play. They include child-friendly graphics that change for each game. The cartoon animal or human characters move dynamically with each stimulus presentation and response (Figure 3). The child's attention is directed to each character and the sound that it makes by means of a 'bouncing ball'. The ball also indicates to the child when to respond. Auditory and visual feedback is given after each response, and there is an indicator to show how far the child has progressed through the 'game'. 
 
 <img src="/files/ftp_upload/2139/2139fig3.jpg" alt="Figure 3" /> 
 Figure 3. A screen shot from the IMAP test battery showing different features in the program interface that have been designed to maintain child engagement. 
 

Motivation and rewards. Although the procedural aspects of test presentation in the IMAP battery are controlled by IHR-STAR, it is essential for the tester to also engage with the child throughout testing. This involves providing positive motivational feedback between tests to engender a feeling of success. Cartoon stickers and certificates are given on completion of testing, and stickers may be used as rewards during testing if necessary.
Session Protocol
<ol>
 <li>For research studies, age-appropriate information sheets for both child and parent are sent out prior to the test session.</li>
 <li>The tester welcomes the child and the parent (if present) and briefly describes what will happen. For testing in a research context, informed written parental consent is obtained if it has not been obtained previously. The child's assent is also obtained.</li>
 <li>An anonymized participant ID number is entered into the appropriate box on the ID screen and this is then automatically appended to all data files collected as part of the test session.</li>
 <li>One out of 10 possible pseudo-randomized test sequences is automatically selected and testing begins.</li>
 <li>The tester introduces the first AP game display to the child and explains the test procedure prior to placing the headphones on the child and starting the familiarization phase for the test. This phase is completed automatically when a preset criterion (e.g. positive response to 4/5 trials) is reached. The child then enters the main testing phase.</li>
 <li>Tests are presented automatically according to the computer-controlled sequence. Prior to each test, the tester instructs the child as appropriate, and gives positive feedback and further encouragement as and when required.</li>
 <li>On completion of the test sequence, the child is rewarded with stickers and a certificate. If present, the parent is provided with a verbal summary of their child's results. These are compared against age-specific norms to account for developmental differences between children. Further management is discussed as appropriate.</li>
</ol>
3. Representative Results
Figure 4 provides examples of good and poor performances for two different children. In the good performance (left panel), the child consistently identifies the 'odd-one-out' and both tracks rapidly converge to the same threshold for intensity level. In other words, both the between- and within-track responses are highly consistent, with minimal deviation. This performance suggests on-task attention has been maintained throughout both tests.
The right panel shows response tracks from a younger child. It is clear, from the rapid convergence to threshold on the first track, that the child has understood the task. However variations in on-task attention are also apparent in both the first (blue) and second (red) tracks. In the first track, the child responds with reasonable consistency up to the last four trials where the child provides a succession of errors, resulting in a higher final threshold than might have been predicted earlier in the track. During the second track, the child fails to achieve performance comparable to the lowest level of detection that was observed in the earlier portion of the first run. There is a succession of six incorrect responses, leading to a progressive increase in the presentation level of the target up to approximately 40 dB above that of the first track. Correct responses then follow, at around trial 13, and the child continues with a series of correct responses until the track finishes. The large inter-track response variation, in conjunction with the large intra-track difference for the second track, suggests a lapse in attention rather than a problem with AP per se. 
 
 <img src="/files/ftp_upload/2139/2139fig4.jpg" alt="Figure 4" /> 
 Figure 4. Two representative graphs demonstrating of performance that can be obtained even when procedural effects are minimized. The left panel is an example of consistent reliable performance for both the first (blue) and second (red) tracks. The right panel provides evidence for lapses of attention after initially good performance (blue) track compared to the second (red) track.
<a href="https://www.jove.com/files/ftp_upload/2139/2139Appendix_A.pdf">Click here for Appendix A.</a> 
<a href="https://www.jove.com/files/ftp_upload/2139/2139Appendix_B.pdf">Click here for Appendix B.</a>

<ol>
	<li>Tallal, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Fine-grained+discrimination+deficits+in+language-learning+impaired+children+are+specific+neither+to+the+auditory+modality+nor+to+speech+perception.">Fine-grained discrimination deficits in language-learning impaired children are specific neither to the auditory modality nor to speech perception.</a> J Speech, Lang, Hearing Res. 33, 616-621 (1990).</li><li>Tallal, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+language+and+literacy+is+a+matter+of+time.">Improving language and literacy is a matter of time.</a> Nature Reviews: Neuroscience. 5, 721-728 (2004).</li><li>Wright, B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Deficits+in+auditory+temporal+and+spectral+resolution+in+language-impaired+children.">Deficits in auditory temporal and spectral resolution in language-impaired children.</a> Nature. 387, 176-178 (2008).</li><li>Bishop, D. V. M., Carlyon, R. P., Deeks, J. M., Bishop, S. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Auditory+temporal+processing+impairment:+Neither+necessary+nor+sufficient+for+causing+language+impairment+in+children.">Auditory temporal processing impairment: Neither necessary nor sufficient for causing language impairment in children.</a> J Speech, Lang, Hearing Res. 42, 1295-1310 (1999).</li><li>Moore, D. R., Ferguson, M. A., Edmondson-Jones, A. M., Ratib, S., Riley, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The nature of auditory processing disorder in children. , (2010).</li><li>Strait, D. L., Kraus, N., Parbery-Clark, A., Ashley, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Musical+experience+shapes+top-down+auditory+mechanisms:+Evidence+from+masking+and+auditory+attention+performance.">Musical experience shapes top-down auditory mechanisms: Evidence from masking and auditory attention performance.</a> Hear Res. , (2009).</li><li>McArthur, G. M. &. a. m. p. ;. a. m. p., Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Frequency+discrimination+deficits+in+people+with+specific+language+impairment:+reliability,+validity,+and+linguistic+correlates.">Frequency discrimination deficits in people with specific language impairment: reliability, validity, and linguistic correlates.</a> J Speech, Lang, Hearing Res. 47, 527-541 (2004).</li><li>Ferguson, M. A., Hall, R. L., Riley, A., Moore, D. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Communication,+listening,+speech+and+cognition+in+children+with+auditory+processing+disorder+(APD)+or+specific+language+impairment+(SLI).">Communication, listening, speech and cognition in children with auditory processing disorder (APD) or specific language impairment (SLI).</a> J Speech, Lang, Hearing Res. , .</li><li>Wechsler, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> WISC-IV(UK). , (2004).</li><li>Korkman, M., Kirk, U., Kemp, S. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> NEPSY: A developmental neuropsychological assessment. , (1998).</li><li>Bishop, D. V. M., North, T., Donlan, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Nonword+repetition+as+a+behaviour+marker+for+inherited+language+impairment:+Evidence+from+a+twin+study.">Nonword repetition as a behaviour marker for inherited language impairment: Evidence from a twin study.</a> J Child Psychol Psyc. 37, 391-403 (1996).</li><li>Barry, J. G., Yasin, I., Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Heritable+risk+factors+associated+with+language+impairments.">Heritable risk factors associated with language impairments.</a> Genes Brain Behav. 6, 66-76 (2007).</li><li>Wechsler, D., Chen, H. -. Y. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Wechsler Abbreviated Scale of Intelligence. , (1999).</li><li>Torgesen, J. K., Wagner, R., Rashotte, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Test of Word Reading Efficiency (TOWRE). , (1999).</li><li>Bishop, D. V. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> The Children's Communication Checklist-2. , (2003).</li><li>Smoski, W. J., Brunt, M. A., Tannahill, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Children's Auditory Processing Performance Scale. , (1998).</li></ol>

No conflicts of interest declared.

Good listening skills (i.e., AP) are believed to provide a firm basis for the further development of important cognitive skills such as speech, language and literacy1-3. Yet, there has been much debate about the nature of the relevant listening skills, if indeed they are relevant, necessary, or sufficient for causing difficulties in language or literacy4. Part of the problem for understanding the role of listening skills in cognitive development reflects the fact that children are very variable in their ability to perform taxing and, from their perspective, rather dull tests of AP ('psychophysical tasks'). This makes it difficult to separate out procedural effects, such as boredom, from more fundamental variations in functioning of central auditory processing pathways. As we have detailed in our protocol, the IMAP test battery was carefully designed to minimize confounds arising from issues associated with the test procedure. In Figure 4, we provide comparisons of performance of two children on a backward masking task. Because IMAP minimizes procedural confounds, and children cannot begin the test until they demonstrate they understand it, we can be confident in ascribing the different performances of these two children to test-specific factors for each child. The inclusion in the IMAP battery of paired AP tests5 and a range of cognitive tests further permits us to explore the reasons for this individual variation. We recently completed a UK population-based study using IMAP5. This showed how response variability and performance on tests tapping cognitive skills, such as attention, explained most of the variation in performance on the AP tests. The population-based study also provided us with standardized measures of performance. These measures are necessary to assess individual performance in the clinic. They are currently being used in a study investigating heritability of listening skills in identical and fraternal twins. This latter study will permit us to develop standardized measures suitable for use with children in the US. Though currently child-focused in design, IMAP can also be used with adults, as demonstrated by Strait et al.,6 who found an important contribution from cognitive skills honed by musical training to the development of auditory processing skills.

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		<div>
		<table border="1">
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		<th>Material Name</th>
		<th>Type</th>
		<th>Company</th>
		<th>Catalogue Number</th>
		<th>Comment</th>
		</tr>
		</thead>
		<tbody>
		
<tr>
<td>IHR-STAR2</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>presentation platform</td>
</tr>
<tr>
<td>IHR-Runner program</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>for pseudo-random order of presentation of tests</td>
</tr>
<tr>
<td>Laptop</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>Processor speed &#x2013; 2 GigaHz; 
RAM &#x2013; 1 Gigabyte; 
Operating system - Windows XP</td>
</tr>
<tr>
<td>USB IHR-audio-device</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>to control sound presentation level and spectrum content</td>
</tr>
<tr>
<td>Response button box</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<td>&nbsp;</td>
<tr>
<td>Headphones</td>
<td>&nbsp;</td>
<td>Sennheiser</td>
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making sense of listening: the imap test battery

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the abilities to extract and use the information encoded in the auditory signal. We refer to these as listening skills (or auditory processing AP). Deficits in these skills are associated with delayed language and literacy development, though the nature of the relevant deficits and their causal connection with these delays is hotly debated.
When a child is referred to a health professional with normal hearing and unexplained difficulties in listening, or associated delays in language or literacy development, they should ideally be assessed with a combination of psychoacoustic (AP) tests, suitable for children and for use in a clinic, together with cognitive tests to measure attention, working memory, IQ, and language skills. Such a detailed examination needs to be relatively short and within the technical capability of any suitably qualified professional. Current tests for the presence of AP deficits tend to be poorly constructed and inadequately validated within the normal population. They have little or no reference to the presenting symptoms of the child, and typically include a linguistic component. Poor performance may thus reflect problems with language rather than with AP. To assist in the assessment of children with listening difficulties, pediatric audiologists need a single, standardized child-appropriate test battery based on the use of language-free stimuli.
We present the IMAP test battery which was developed at the MRC Institute of Hearing Research to supplement tests currently used to investigate cases of suspected AP deficits. IMAP assesses a range of relevant auditory and cognitive skills and takes about one hour to complete. It has been standardized in 1500 normally-hearing children from across the UK, aged 6-11 years. Since its development, it has been successfully used in a number of large scale studies both in the UK and the USA. IMAP provides measures for separating out sensory from cognitive contributions to hearing. It further limits confounds due to procedural effects by presenting tests in a child-friendly game-format. Stimulus-generation, management of test protocols and control of test presentation is mediated by the IHR-STAR software platform. This provides a standardized methodology for a range of applications and ensures replicable procedures across testers. IHR-STAR provides a flexible, user-programmable environment that currently has additional applications for hearing screening, mapping cochlear implant electrodes, and academic research or teaching.

Watch this Scientific Journal Video about Making Sense of Listening: The IMAP Test Battery at JoVE.com

Making Sense of Listening: The IMAP Test Battery

A test battery (IMAP) for performing an in-depth assessment of auditory and cognitive abilities contributing to listening skills is described. It is quick to administer, child-friendly and free from linguistic confounds. Stimulus generation and protocol management are controlled via a software platform (IHR-STAR) to ensure replicable procedures.

The ability to hear is only the first step towards making sense of the range of information contained in an auditory signal. Of equal importance are the ...

making-sense-of-listening-the-imap-test-battery

Research

JoVE Journal

Medicine

15.7K Views.  MRC Institute of Hearing Research. A test battery (IMAP) for performing an in-depth assessment of auditory and cognitive abilities contributing to listening skills is described. It is quick to administer, child-friendly and free from linguistic confounds. Stimulus generation and protocol management are controlled via a software platform (IHR-STAR) to ensure replicable procedures.

Video: Making Sense of Listening: The IMAP Test Battery

Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder

In addition to impairments in social communication and the presence of restricted interests and repetitive behaviors, deficits in sensory processing are now recognized as a core symptom in autism spectrum disorder (ASD). Our ability to perceive and interact with the external world is rooted in sensory processing. For example, listening to a conversation entails processing the auditory cues coming from the speaker (speech content, prosody, syntax) as well as the associated visual information (facial expressions, gestures). Collectively, the &#8220;integration&#8221; of these multisensory (i.e., combined audiovisual) pieces of information results in better comprehension. Such multisensory integration has been shown to be strongly dependent upon the temporal relationship of the paired stimuli. Thus, stimuli that occur in close temporal proximity are highly likely to result in behavioral and perceptual benefits &#8211; gains believed to be reflective of the perceptual system&#39;s judgment of the likelihood that these two stimuli came from the same source. Changes in this temporal integration are expected to strongly alter perceptual processes, and are likely to diminish the ability to accurately perceive and interact with our world. Here, a battery of tasks designed to characterize various aspects of sensory and multisensory temporal processing in children with ASD is described. In addition to its utility in autism, this battery has great potential for characterizing changes in sensory function in other clinical populations, as well as being used to examine changes in these processes across the lifespan.

We describe how to implement a battery of behavioral tasks to examine the processing and integration of sensory stimuli in children with ASD. The goal is to characterize individual differences in temporal processing of simple auditory and visual stimuli and relate these to higher order perceptual skills like speech perception.

In addition to impairments in social communication and the presence of restricted interests and repetitive behaviors, deficits in sensory processing are ...

Behavior

Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children &#8211; Working Memory (CABC-WM)

The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of working memory in young school-age children. Working memory deficits have been identified in children with language-based learning disabilities, including dyslexia1,2 and language impairment3,4, but it is not clear whether these children exhibit deficits in subcomponents of working memory, such as visuospatial or phonological working memory. The CABC-WM is administered on a desktop computer with a touchscreen interface and was specifically developed to be engaging and motivating for children. Although the long-term goal of the CABC-WM is to provide individualized working memory profiles in children, the present study focuses on the initial success and utility of the CABC-WM for measuring central executive, visuospatial, phonological loop, and binding constructs in children with typical development. Immediate next steps are to administer the CABC-WM to children with specific language impairment, dyslexia, and comorbid specific language impairment and dyslexia.

Assessing Working Memory in Children: The Comprehensive Assessment Battery for Children &amp;#8211; Working Memory (CABC-WM)

Working memory predicts a significant amount of variance for a variety of cognitive tasks, including speaking, reading, and writing. However, few tools are available to assess working memory in children. We present an innovative, computer-based battery that comprehensively assesses different components of working memory in school-age children.

The Comprehensive Assessment Battery for Children - Working Memory (CABC-WM) is a computer-based battery designed to assess different components of ...

Portable Intermodal Preferential Looking (IPL): Investigating Language Comprehension in Typically Developing Toddlers and Young Children with Autism

One of the defining characteristics of autism spectrum disorder (ASD) is difficulty with language and communication.1 Children with ASD's onset of speaking is usually delayed, and many children with ASD consistently produce language less frequently and of lower lexical and grammatical complexity than their typically developing (TD) peers.6,8,12,23 However, children with ASD also exhibit a significant social deficit, and researchers and clinicians continue to debate the extent to which the deficits in social interaction account for or contribute to the deficits in language production.5,14,19,25
Standardized assessments of language in children with ASD usually do include a comprehension component; however, many such comprehension tasks assess just one aspect of language (e.g., vocabulary),5 or include a significant motor component (e.g., pointing, act-out), and/or require children to deliberately choose between a number of alternatives. These last two behaviors are known to also be challenging to children with ASD.7,12,13,16
We present a method which can assess the language comprehension of young typically developing children (9-36 months) and children with autism.2,4,9,11,22 This method, Portable Intermodal Preferential Looking (P-IPL), projects side-by-side video images from a laptop onto a portable screen. The video images are paired first with a 'baseline' (nondirecting) audio, and then presented again paired with a 'test' linguistic audio that matches only one of the video images. Children's eye movements while watching the video are filmed and later coded. Children who understand the linguistic audio will look more quickly to, and longer at, the video that matches the linguistic audio.2,4,11,18,22,26
This paradigm includes a number of components that have recently been miniaturized (projector, camcorder, digitizer) to enable portability and easy setup in children's homes. This is a crucial point for assessing young children with ASD, who are frequently uncomfortable in new (e.g., laboratory) settings. Videos can be created to assess a wide range of specific components of linguistic knowledge, such as Subject-Verb-Object word order, wh-questions, and tense/aspect suffixes on verbs; videos can also assess principles of word learning such as a noun bias, a shape bias, and syntactic bootstrapping.10,14,17,21,24 Videos include characters and speech that are visually and acoustically salient and well tolerated by children with ASD.

Portable Intermodal Preferential Looking IPL: Investigating Language Comprehension in Typically Developing Toddlers and Young Children with Autism

A reliable home-based way to assess the language comprehension of very young typically developing children, as well as those with autism, is described. The method analyzes children's eye gaze while viewing side-by-side images but hearing an audio that matches only one image. Stimuli are designed with young participants in mind.

One  of the defining characteristics of autism spectrum disorder (ASD) is difficulty  with language and communication.1  Children with ASD's onset of ...

Using Eye Movements Recorded in the Visual World Paradigm to Explore the Online Processing of Spoken Language

In a typical eye tracking study using the visual world paradigm, participants' eye movements to objects or pictures in the visual workspace are recorded via an eye tracker as the participant produces or comprehends a spoken language describing the concurrent visual world. This paradigm has high versatility, as it can be used in a wide range of populations, including those who cannot read and/or who cannot overtly give their behavioral responses, such as preliterate children, elderly adults, and patients. More importantly, the paradigm is extremely sensitive to fine grained manipulations of the speech signal, and it can be used to study the online processing of most topics in language comprehension at multiple levels, such as the fine grained acoustic phonetic features, the properties of words, and the linguistic structures. The protocol described in this article illustrates how a typical visual world eye tracking study is conducted, with an example showing how the online processing of some semantically complex statements can be explored with the visual world paradigm.

The visual world paradigm monitors participants' eye movements in the visual workspace as they are listening to or speaking a spoken language. This paradigm can be used to investigate the online processing of a wide range of psycholinguistic questions, including semantically complex statements, such as disjunctive statements.

In a typical eye tracking study using the visual world paradigm, participants' eye movements to objects or pictures in the visual workspace are recorded ...

Examining Online Syntactic Processing of Spoken Complex Sentences in Chinese Using Dual-Modal Interference Tasks

Working memory (WM) plays a central role in the comprehension of complex sentences. Its function in the processing of spoken complex sentences is especially evident because spoken complex sentence processing is memory-intensive. The dual-modal interference paradigm has been used to examine how the WM system is involved in complex syntactic processing. This article presents two exemplar experiments involving auditory processing with either intra- or extrasentential interferences. In the first experiment, auditory stimuli [spoken-Chinese relative clause (RC) sentences with two syntactic types: subject-gapped (SRC) vs. object-gapped (ORC)] are interfered with via a visually presented lexical decision task within a sentence and manipulated using three different interference timepoints. In the second experiment, the same auditory stimuli, presented via an auditory window moving technique, are interfered with via a visually presented digital recall task beyond the sentence and manipulated using three digital memory loads. By assessing how the primary task of comprehending the RC sentences is affected by the secondary task, we can tackle the controversial issue concerning Chinese RC processing asymmetry. Our results reveal different patterns of RC processing compared to those reported in previous studies. Experiment 1 manifests no clear RC processing advantages in either SRC or ORC; however, a preference for ORC is observed at the ends of sentences, and a preference for SRC is found at the main verb site. Likewise, Experiment 2 presents a dynamic pattern. Under a no-digit load, SRCs show processing advantages in the RC marker region. However, under higher-digit-load interference, ORCs show processing advantages in the same region. These results lead to the conjecture that no obvious or intrinsic processing asymmetry exists in the processing of Chinese RCs. Using the approach of assessing specific interference during syntactic processing, these experiments demonstrate future research applications that explore the processing metrics of spoken sentences involving working memory.

Here, we present a protocol employing dual-modal interference tasks to examine online processing of spoken-Chinese relative clause sentences. Two exemplar experiments involving auditory processing with intra- and extrasentential interferences are described. The paradigm provides a methodology for addressing the nature of working memory and its effects on sentence processing.

Working memory (WM) plays a central role in the comprehension of complex sentences. Its function in the processing of spoken complex sentences is ...

Universal Screening for Prevention of Reading, Writing, and Math Disabilities in Spanish

The purpose of this study was to describe a Spanish protocol that includes reading, writing, and math Curriculum-Based Measures (CBMs) aimed at early detection of students at risk of presenting learning disabilities (LD). Early identification of LD is a critical component of the Response to Intervention (RtI) model. In early grades, the screening of foundational skills mentioned above can provide a data-based guideline for identifying students requiring a more intensive response-based intervention before starting elementary school. We designed different CBMs based on indicators of basic early reading, writing, and math skills [Indicadores de Progreso de Aprendizaje en Lectura, Escritura y Matem&#225;ticas, IPAL, IPAE, and IPAM respectively]&#160;that aim to fulfill the twofold objective of universal screening and evaluation of the Spanish students&#8217; progress. For reading, IPAL includes alphabetic principle, phonological awareness, concepts about print, and riddles in kindergarten. In first and second grades, IPAL includes alphabetic principle, nonsense words fluency, maze sentences, and oral reading fluency. In addition, it includes phonemic segmentation for first grade and prosody for second grade. For writing, IPAE includes copying letters, writing allographs, dictated letters, dictated words with arbitrary spelling, dictated words with rule-based spelling, dictated nonsense words, dictated sentences, writing sentences, and writing a story for first-third grades. Finally, for math, IPAM includes number comparison, missing number, number identification, quantity array, and counting aloud for kindergarten, and number comparison, multi-digit computation, missing number, single-digit computation, and place value for first-third grades.

This work presents a protocol to administrate Spanish Curriculum-Based Measures for the early detection of reading, math, and writing difficulties. These tools could help practitioners and applied researchers working in the context of the Response to Intervention model.

The purpose of this study was to describe a Spanish protocol that includes reading, writing, and math Curriculum-Based Measures (CBMs) aimed at early ...

Multimedia Battery for Assessment of Cognitive and Basic Skills in Mathematics (BM-PROMA)

Learning mathematics is a complex process that requires the development of multiple domain-general and domain-specific skills. It is therefore not unexpected that many children struggle to stay at grade level, and this becomes especially difficult when several abilities from both domains are impaired, as in the case of mathematical learning disabilities (MLD). Surprisingly, although MLD is one of the most common neurodevelopmental disorders affecting schoolchildren, most of the diagnostic instruments available do not include assessment of domain-general and domain-specific skills. Furthermore, very few are computerized. To the best of our knowledge, there is no tool with these features for Spanish-speaking children. The purpose of this study was to describe the protocol for the diagnosis of Spanish MLD children using the BM-PROMA multimedia battery. BM-PROMA facilitates the evaluation of both skill domains, and the 12&#160;tasks included for this purpose are empirically evidence-based. The strong internal consistency of BM-PROMA and its multidimensional internal structure are demonstrated. BM-PROMA proves to be an appropriate tool for diagnosing children with MLD during primary education. It provides a broad cognitive profile for the child, which will be relevant not only for diagnosis but also for individualized instructional planning.

Multimedia Battery for Assessment of Cognitive and Basic Skills in Mathematics BM-PROMA

BM-PROMA is a valid and reliable multimedia diagnostic tool that can provide a complete cognitive profile of children with mathematical learning disabilities.

Learning mathematics is a complex process that requires the development of multiple domain-general and domain-specific skills. It is therefore not ...

Computerized Dyslexia Assessment for Spanish-Speaking Children Using SICOLE-R

Advancing Dyslexia Assessment in Children Through Computerized Testing

The acquisition of reading skills is an intricate process that demands the cultivation of various domain-general and domain-specific abilities. Consequently, it is unsurprising that many children grapple with maintaining proficiency at the grade level, particularly when confronted with challenges spanning multiple abilities across both domains, as observed in individuals with reading difficulties. Strikingly, despite reading difficulties being among the most prevalent neurodevelopmental disorders affecting school-aged children, the majority of available diagnostic tools lack a comprehensive framework for assessing the full spectrum of cognitive skills linked to dyslexia, with minimal computerized options. Notably, there are currently limited tools with these features available for Spanish-speaking children. The aim of this study was to delineate the protocol for diagnosing Spanish-speaking children with reading difficulties using the Sicole-R multimedia battery. This tool for elementary grades focuses on evaluating cognitive skills that are associated with dyslexia as prescribed by the scientific literature. Specifically, it concentrates on assessing a range of cognitive abilities that studies have demonstrated to be linked to dyslexia. This focus is based on the observation that individuals with dyslexia typically exhibit deficits in several of the cognitive areas evaluated by this digital tool. The robust internal consistency and multidimensional internal structure of the battery were demonstrated. This multimedia battery has proven to be a fitting tool for diagnosing children with reading difficulties in primary education, offering a comprehensive cognitive profile that is valuable not only for diagnostic purposes but also for tailoring individualized instructional plans.

Author Spotlight: Validation of SICOLE-R for Assessing Cognitive and Reading Skills in Spanish-Speaking Children and Its Role in Personalized Education

The Multimedia Battery for Assessment of General-Domain and Specific-Domain Skills in Reading is a reliable and valid multimedia battery designed to assess cognitive and basic reading skills. It enables the generation of a comprehensive cognitive and reading performance profile, which is particularly beneficial for children with dyslexia.

The acquisition of reading skills is an intricate process that demands the cultivation of various domain-general and domain-specific abilities. ...

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Investigating potential pharmacodynamic effects in an early phase of central nervous system (CNS) drug research can provide valuable information for further development of new compounds. A computerized and thoroughly validated battery of neuropsychological and neurophysiological tests has been shown to be sensitive to detect drug-induced effects of multiple new and existing compounds. The test battery covers the main CNS domains, which have been shown to respond to drug effects and can be repeatedly administered following drug administration to characterize the concentration-effect profile of a drug.
The standard tests in the battery are saccadic eye movement, smooth pursuit eye movement, the Bowdle visual analog scale (VAS), the Bond and Lader VAS, body sway, adaptive tracking, visual verbal learning, and quantitative electroencephalography (qEEG). However, the test battery is adaptive in nature, meaning that it can be composed and adjusted with tests fit to investigate specific drug classes, or even specific receptors.
Showing effects of new cholinergic drugs designed to have a pro-cognitive outcome has been difficult. The pharmacological challenge model is a tool for early proof-of-pharmacology. Here, a marketed drug is used to induce temporary and reversible disease-like symptoms in healthy subjects, via a pharmacological mechanism related to the disease that is targeted as indication for the new compound. The test battery was implemented to investigate the potential of the nicotinic receptor antagonist mecamylamine to be used as a challenge model for cholinergic dysfunction, as seen in neurodegenerative disorders.
A worsening of scores in a dose dependent manner on the visual verbal learning test (VVLT; a test for learning and memory abilities) and the adaptive tracking test (a measure of visuomotor control and arousal), in particular, showed that the test battery is sensitive to showing acute pharmacodynamic effect after administration of anti-cholinergic drugs.

A validated computerized battery of neuropsychological and neurophysiological tests is used to study pharmacodynamic effects on the central nervous system of newly developed drugs in early phase development. To demonstrate the test battery, the acute effects of mecamylamine and the reversal of these effects by two agonist drugs are described.

Investigating potential pharmacodynamic effects in an early phase of central nervous system (CNS) drug research can provide valuable information for ...

Neuroscience

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages

Cochlear implant (CI) provision is the most effective clinical treatment to restore hearing performance in individuals with profound sensorineural hearing loss (SNHL). It has been successful in providing improved speech perception outcomes, especially in quiet environments. However, speech perception performance within complex environments, lexical tone recognition, and music perception have been shown to only improve with newer fine structure coding strategies or related techniques. Therefore, the methods used to assess hearing performance in noisy environments, lexical tone recognition, and music perception are of vital importance. These assessments must reflect the postoperative outcomes and also provide guidance for the programming, rehabilitation, and application of new coding strategies. In this study, hearing performance in simple and complex situations was evaluated before and after upgrading to a fine structure strategy. The participants were a cohort of Mandarin-speaking adolescents, who were experienced CI users. The comprehensive clinical workflow involved assessments of speech in quiet conditions, speech in noisy conditions, lexical tone recognition, and music perception. This battery of tests is explained in detail, from the coding strategy to the test methods, including the test process, environment, device, material, and order. The details that require special attention are discussed, such as the position of the participants, the angle of the loudspeaker, the intensity of the sound, the noise type, the practice test, and the way of answering questions. Each test step, method, and material for speech, lexical tone, and music perception is presented in detail. Finally, the clinical results are discussed.

This paper describes a battery of tests used to clinically assess the hearing performance of adolescent, Mandarin-speaking, experienced cochlear implant users upgraded to a new fine structure coding strategy. The battery of tests include speech in quiet conditions, speech in noisy conditions, lexical tone, and music perception.

Cochlear implant (CI) provision is the most effective clinical treatment to restore hearing performance in individuals with profound sensorineural hearing ...