Bottom-up and Top-down Training Apps for Temporal Pattern Recognition in Children

Abstract

Auditory processing (AP) difficulties in children are often associated with significant learning, listening, and communication issues. The precise relationship between AP and cognitive skills such as memory, processing speed, attention, and language knowledge is currently ill-defined. This may be due to difficulty identifying the cognitive contributions, eliminating co-morbid effects, and the variable nature of AP difficulties. Management of AP difficulties can be from a bottom-up approach (the use of personal listening systems to enhance the auditory signal or training to improve auditory-specific skills) or from a top-down approach (training to improve overall cognitive processing and thereby listening skills). While a bottom-up approach has typically been used for children, more research is emerging about the use of training programmes to enhance auditory learning and listening skills, as well as memory and attention. This project aimed to characterise the effects of bottom-up and top-down iPad-based auditory training programs on auditory processing skills in children. It also aimed to investigate the relationship between an auditory processing skill and cognitive resources, such as working memory and processing speed. It was hypothesised that children’s performance in the assessment battery would improve after training on either one or both of the auditory training app games, and that there would be positive correlations between tests of cognitive resources and auditory processing. 12 children aged 7 to 10 years old, previously identified to perform below 100% on a three-tone Frequency Pattern Test, were divided into two age- and gender-matched groups which participated in a six-week long auditory training programme using one of two iPad application games. These were Auditory Processing Studio, which takes a bottom-up approach and Auditory Workout, which takes a top-down approach. Auditory processing, working memory, and processing speed skills, as well as self- and parent-assessed listening behaviours, were tested before and after the training program. No significant difference between the two groups was observed in tests of temporal sequencing, working memory, processing speed, or self- and parent-assessed listening skills. There was no direct benefit with either the top-down or bottom-up training approaches used in this study. However, this study has shown that tablet-based auditory training games have significant appeal to children for use at home and in the clinic.