İşitsel İşlemleme Basamakları
Özet
İşitsel işlemleme, çevredeki seslerin kulak tarafından alınıp beyinde anlamlandırılmasını, algısal, bilişsel ve dil fonksiyonlarını içeren karmaşık nörolojik bir süreçtir. Periferik ve santral işitme mekanizmalarının koordineli çalışmasıyla gerçekleşen bu süreç; ses lokalizasyonu, ayırt etme ve patern algısı gibi davranışsal boyutları kapsar. İşitsel işlemleme basamaklarındaki aksamalar, özellikle afazili bireylerde yaygın görülen işitsel işlemleme bozukluklarına (İİB) yol açar. Afazinin türüne göre bireylerde; duyulan kelimelerin ses analizinin yapılamadığı saf sözcük sağırlığı, leksikal seviyedeki bozulmayı ifade eden sözcük biçimi sağırlığı veya kelimelerin tekrar edilip anlaşılamadığı sözcük anlamı sağırlığı gibi farklı klinik tablolar ile dil, hafıza, okuma ve hesaplama problemleri açığa çıkabilmektedir. İİB tanısı için tek bir test yeterli olmayıp, elektrofizyolojik (ABR, MLR, P300) ve davranışsal (dikotik konuşma, temporal sıralama) test bataryalarının multidisipliner bir yaklaşımla birlikte değerlendirilmesi gereklidir. Tedavi süreçlerinde ise bireysel ihtiyaçlar ve aile katılımı gözetilerek iletişim modalitelerinin yeniden düzenlenmesi hedeflenir.
Auditory processing is a complex neurological process involving perceptual, cognitive, and language functions through which sounds received by the ear are interpreted in the brain. Occurring through the coordinated operation of peripheral and central hearing mechanisms, this process encompasses behavioral dimensions such as sound localization, discrimination, and pattern perception. Disruptions in auditory processing stages lead to auditory processing disorders (APD), which are commonly observed in individuals with aphasia. Depending on the type of aphasia, different clinical profiles may emerge, including word sound deafness where phonetic analysis fails, word form deafness indicating impairment at the lexical level, or word meaning deafness where words can be repeated but not understood, alongside various language, memory, reading, and calculation problems. For an accurate APD diagnosis, a single test is insufficient; instead, a combination of electrophysiological (ABR, MLR, P300) and behavioral (dichotic speech, temporal ordering) test batteries must be comprehensively evaluated. In treatment processes, rearranging communication modalities is targeted by considering individual needs and family involvement.
Referanslar
Anderson, K. L., & Matkin, N. (1996). PRESCHOOL SIFTER. Retrieved September, 16, 2007.
American Speech-Language-Hearing Association. (1996). Central auditory processing: Current status of research and implications for clinical practice. American Journal of Audiology,5(2), 41–54.
American Speech-Language-Hearing Association. (2005). (Central) auditory processing disorders.
Benson,D.F. (1967). Fluency in aphasia. Ed. Benson,D.F., Ardila, A. Aphasia: A Clinical Perspective. OxFord University Press, 268.
Benson,D.F., Ardila, A. (1996). Aphasia: A Clinical Perspective. OxFord University Press, 262-280.
Brookshire, R.H. (1987). Auditory Language Comprehension Disorders in Aphasia, Topics in Language Disorders,8, 1; 11-23.
Fifer, R. C., Jerger, J. F., Berlin, C. I., Tobey, E. A., & Campbell, J. C. (1983). Development of a dichotic sentence identification test for hearing-impaired adults. Ear and Hearing, 4, 6;300-305.
Fisher, L., & Rubenstein, G. (1975). Developmental aspects of auditory and visual scanning. Perceptual and Motor Skills, 40,2; 583-586.
Franklin, S., Turner, J. E., & Ellis, A. W. (1992). ADA Comprehension Battery: Action for dysphasic adults. London, England: Action for Dysphasic Adults.
Gorno-Tempini M.L., Hillis A.E., Weintraub S., Kertesz A., Mendez M., Cappa S.F., et al. (2011). Classification of primary progressive aphasia and its variants, Neurology, 76, 1006–14.
Heilman,L.E., McNeil,M.R., Hill,K.J., Pratt,S.R. (2008). An examination of the effects of mode of access on the computurized revised token test. Clinical Aphasiology Conference, Charlottesville, VA.
Howard, D., & Franklin, S. (1989). Missing the meaning? A cognitive neuropsychological study of the processing of heard words. Cambridge, MA: MIT Press.
Katz, J. (1968). The SSW test: An interim report. Journal of Speech and Hearing Disorders, 33,2;132-146.
Kay, J., Lesser, R., & Coltheart, M. (1992). Psycholinguistic Assessments of Language Processing in Aphasia (PALPA). Hove, England: Lawrence Erlbaum.
Keith, R. W. (2000). Development and standardization of SCAN-C test for auditory processing disorders in children. Journal of the American Academy of Audiology, 11,08; 438-445.
Keith, R. (2009). Controversies in standardization of auditory processing tests. Controversies in central auditory processing disorder, 169-186.
McNeil,M.R.,Pratt,S.,Sung,J.E.,Szuminsky,N.,Ventura,M.,Kim, .,Fosset, T.R.D., Doyle,P.J., Musson,N. (2008a). Test-retest reliability of the auditory computurized revised token test and three experimental reading versions in normal elderly individuals and persons with aphasia. Clinical Aphasiology Conference, Jackson Hole,W.Y.
Meyers, J. E., Roberts, R. J., Bayless, J. D., Volkert, K., & Evitts, P. E. (2002). Dichotic listening: Expanded norms and clinical application. Archives of Clinical Neuropsychology, 17,1; 79-90.
Morris, J., Franklin, S., Ellis, A. W., Turner, J., & Bailey, P. J. (1996). Remediating a speech perception deficit in an aphasic patient. Aphasiology, 10,2; 137–158.
Morris, J., Franklin S. (2011) Disorders of Auditory Comprehension İ. Papathanasiou, P. Coppens (Ed.) Aphasia and Related Neurogenic Communication Disorders (p. 113-129) JONES & BARTLETT LEARNING.
Morris, J., Frenklin, S. (2013) Disorders of Auditory comprehension In: Aphasia and Related Neurogenic Communication Disorders (ed: Papathanasiou, I.), Jones & Bartlett Learning, 113-126.
Musiek, F. E. (1983). Assessment of central auditory dysfunction: the dichotic digit test revisited. Ear and hearing, 4,2; 79-83.
O’Hara, B., & Mealings, K. (2018). Developing the auditory processing domains questionnaire (APDQ): a differential screening tool for auditory processing disorder. International Journal of Audiology, 57,10; 764-775.
Robson H., Grube M., Lambon Ralph M.A., Griffiths T.D., Sage K. (2013). Fundamental deficits of auditory perception in Wernicke’s aphasia, Cortex, 49,7;1808–1822.
Swinburn, K., Porter, G., & Howard, D. (2004). The Comprehensive Aphasia Test. Hove, England: Psychology Press.
Türkyılmaz, M.D. (2009). Bilgisayarlı Simge Afazi Test’inin Türkçe Adaptasyon Ve Standardizasyon Çalışması [Doktora Tezi, Hacettepe Üniversitesi ].
Walker J.P., Joseph L. Goodman J. (2009). The production of linguistic prosody in subjects with aphasia, Clinical Linguistics and Phonetics, 23,7; 529–549.
