Presentation on theme: "Constraint Induced Auditory Therapy (CIAT)"— Presentation transcript:
1Constraint Induced Auditory Therapy (CIAT) Annette Hurley, Ph.D. & Bradley Davis, Au.D.Dept. of Communication DisordersSchool of Allied Health Professions, Louisiana State University Health Sciences Center - New OrleansCASE 2: CVACase 5: LKSBACKGROUNDCase 2. AMLR-12 year old male-Acquired (C)APD as result of Landau-Kleffner Syndrome-Abnormal spiking in the left temporal lobe-Completed Fast ForWord-Completed CIAT for 2 semesters (14 Sessions)BioMARK is within normal limits after CIAT. An increase in N1-P2 amplitude is shown after Fast ForWord.-46 year old male-MRI revealed a large left frontal lobe lesionextending to the parietal lobe.-Normal peripheral hearing-Eight CIAT sessions-Subjective improvements in hearingfrom communicative partner (wife)Constraint Induced Auditory Therapy (CIAT) is an auditory training program for children and adults. It is based on core principles of the Dichotic Interaural Intensity Difference (Musiek & Shochat, 1998). CIAT strengthens auditory processing by targeting the weaker ear through intense auditory training. This investigation reviews CIAT exercises and case reports from six patients with temporal lobe damage from acquired (C)APD from stroke, meningitis, or Landau-Kleffner Syndrome. Positive behavioral and electrophysiological findings following CIAT are reviewed.A slight decrease in Wave Pa latencywas evident after CIAT.Case 5. BioMARK ALERCIAT ExercisesDichotic Numbers Single and Doublepair presented at +20, +15, +10, and +5Signal to Noise Ratio and at 500, 200,00, 50, and 10 msec inter-stimulusintervals.2. Dichotic Sentences: 3, 4, 5, 6 & 7syllable sentences.Semantic Monosyllabic Words: Spondees, Antonyms, Related words, etc.CVs: pa, ba, etc., with expansion.Stories with babble in the opposite ear.CASE 3: CVACase 3. Auditory Late Evoked Response .-29 year old Female-Onset 8/15/07-College Graduate: Chef/Restaurant Owner-Extremely Motivated to try auditory therapy(and/or other alternative therapies)-Broca’s Aphasia: halting telegraphic speech, single wordsRight dichotic scores are within normal limits.CIAT training began 9/08; 1 hour per weekongoing cognitive training continuesAn improvement in the N1-P2 amplitude after CIATis noted.Case 6: Meningitis-8 year old female-History of infantile Meningitis-Abnormal Spiking in Right Frontal & Temporal Lobe-Exprpessive Language and Speech Disorder-Began Language therapy June, 2009-Began CIAT June, 2009 (15) 30 minute sessions-Difficulty in maintaining focusLeft dichotic scores improved from 0% to 60% for digits; greater improvement for linguistic stimuli.Improved BioMARK from ‘abnormal’ to normal for the right ear after CIAT is shown below.A representation ofipsilateral and dominant contralateral pathways.Case 1: CVA-49 year old male with left temporal parietal lesion.-Normal peripheral hearing-Impaired music perception-Difficulty understanding-Right ear deficit on dichotic tests-CIAT training- 10 sessions-Subjective improvement in hearing-Right ear pathway improved from 0%to scores at normal limits (>90%).Case 4: CVA-49 year old female-Mixed non-fluent Aphasia-Associates Degree in Accounting: Bookkeeper-Very Motivated-Effortful, non-fluent perseverative speech; severe word finding moderately impaired comprehension skills-Speech/language therapy began January, 2008-CIAT began September 2009.-Dichotic Scores (Right Directed ear) improvedfrom 0% to >80%.An increase in N1-P2 amplitude is shown for the ALER and a a slight decrease in Waves V and A of the BioMARK after CIAT..A slight improvement in ABR Wave V latency is shown below.Improved Na-Pa amplitude is depicted in the Auditory Middle Latency Response (AMLR) recordingsDiscussionFigure 2. ABRFigure 3. AMLREach patient showed improvement on behavioral dichotic testsfollowing CIAT.Each adult patient reported subjective improvements in hearing following CIAT.Each patient showed improvements in electrophysiological recordings, demonstrating plasticity at various levels of the central auditory nervous system following CIAT.