Treatment of auditory processing in noise in individuals with mild aphasia: pilot study

Auditory comprehension impairments are a common manifestation of aphasia in individuals who incur left cerebral damage. Even individuals with mild aphasia often report difficulties with auditory processing in daily activities, such as listening to the television or movies. These difficulties tend to be exacerbated in deleterious listening conditions, such as noisy medical facilities where these individuals participate in rehabilitation, or in noisy restaurants once they resume daily activities. A large literature has examined factors that impact auditory comprehension impairments in individuals with aphasia, such as linguistic components [1] and processing conditions (e.g., rate of speech, time to respond) [2]. One area with more limited systematic study is the impact of degraded listening conditions for auditory processing abilities in individuals with aphasia. In the distant past, Basili et al. [3] reported that individuals with aphasia had inordinate difficulty listening to speech when presented in the presence of either white noise or speech noise as compared to healthy control subjects. More recent studies have reported the detrimental effects of white noise or MRI Purpose: Listening in noise challenges listeners with auditory comprehension impairments in aphasia. We examined the effects of Trivia Game, a computerized program with questions spoken in increasing levels of background noise with success in the game. Methods: We piloted Trivia Game in four individuals with chronic aphasia and mild auditory comprehension impairments. Participants played Trivia Game for 12 twenty-minute sessions. In addition to the Western Aphasia Battery (WAB), we measured outcomes on Quick Speech in Noise (QSIN), a sentence repetition test, administered in auditory (AUD) and auditory+visual (AV) conditions as signal-to-noise ratio varied from 25 to 0 dB. Results: All four participants showed progress within the game in the noise level attained. Increases in repetition accuracy were seen in two participants for the QSIN AUD condition (average of 5.5 words), and in three participants for QSIN AV (average of 16.5 words). One individual increased performance on the WAB. Conclusions: Use of Trivia Game led to improved auditory processing abilities in all four individuals with aphasia. Greater gains noted in the AV condition over AUD suggest that Trivia Game may facilitate speech-reading skills to support comprehension of speech in situations with background noise.