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Öğe Are serum levels of trace elements in children with auditory neuropathy within normal limits? A pilot study(Canadian Soc Clinical Investigation, 2010) Muluk, Nuray Bayar; Yalcinkaya, Fulya; Arikan, Osman Kuersat; Cirpar, Oezden; Kaygusuz, Sedat; Ercan, VarolObjectives: To determine whether trace elements that are essential for neural function play a role in the pathophsiology and etiology of auditory neuropathy (AN).. Materials and methods: Patients diagnosed with auditory neuropathy consisted of eight children (two male, six female). The blood tests including the measurement of sodium, potassium, chloride, calcium, phosphorus, iron, copper and magnesium were done in children with AN during their routine care. Results: Of the eight children with AN, many had serum levels outside the normal range: one had low sodium, two had low potassium, one had low chloride, two had high zinc and three had low zinc, two had low calcium and two had higher than normal phosphorus. Conclusion: Although some serum trace element levels in our patients were higher or lower than normal values, the mean values were within normal limits. Thus, we were unable to detect a relationship between serum trace element levels and AN-. In the future, larger studies should be conducted to confirm these findings.Öğe Evaluation for language and speech development in Kabuki make-up syndrome: A case report(Elsevier Ireland Ltd, 2009) Muluk, Nuray Bayar; Yalcinkaya, Fulya; Budak, Bilgehan; Guenduez, Selen; Ayas, KivancKabuki make-up syndrome (KMS) is defined as a rare syndrome with mental retardation, growth deficiency and multiple anomalies of unknown cause. Cases have a characteristic facial appearance of broad and low auricles, wide forehead, broad and flattened nose root. In this article, 4-year, 10-month-old boy with speech delay reported due to characteristics of the facial appearance is considered as KMS, a rare syndrome. Otological, audiological and developmental evaluation of the patient consisted of six parameters. (1) ENT examination: normal. (2) Audiological findings were at normal hearing levels. (3) General development (according to the Denver II test), was normal. (4) Language and speech development: receptive language development was 2 years more than the chronological age. However in expressive language development, there was 5-month delay which was likely to complete by training in a short time. (5) The development of speech sounds and articulation: the delay is observed in CVC words. Speech sounds of /l/, /t/, /r/ and /g/ were evaluated as "distorted expression". He used /v/ instead of /l/; /y/ instead of /r/; /d/ instead of /g/. (6) Observations: diffident, deficit in self-confidence, and difficulty in communicating have been observed. Unlike the cases in literature, mental retardation, growth deficiency and learning difficulties were not found in our case with KMS. Normal findings were obtained in five parameters. Only the /l/, /r/ and /g/ speech sounds were expressed as distorted. For our case, we planned to follow him in the future to see whether developmental and central auditory processing disorders will occur or not. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Öğe Importance of Pre-Educational and Post-Educational Language Tests and Effect of Training on the Diagnosis of Auditory Processing Disorders (APDs) in Children(Aves, 2010) Muluk, Nuray Bayar; Yalcinkaya, FulyaObjective: Aim of this study was to evaluate the importance of pre-educational and post-educational language tests for childs with language problems and effect of training on the diagnosis of auditory processing disorders (APDs). We used "Synchronously-understanding the Unplanned Event through its Picture and Listening" (SUEPL)-Training Method. Materials and Methods: The study consisted of 10 childs, referred with the suspect of APD. There was expressive language delay (DEL) in eight childs (8 boys). Their receptive language development and intelligence levels were normal. In 2 childs (1 boys, 1 girl), expressive and receptive language developments were in normal levels; but there were additional problems such as listening problems and attention disorders. The training method of SUEPL was applied to the childs. After the education with SUEPL, symptoms of APD were evaluated and reported in these 10 childs, in pre- and post-SUEPL-training periods. Difference between pre-educational and post-educational receptive language levels were analyzed by "Chi-Square Test". Results: The childs' pre-educational language development levels showed that only in childs 1 and 2, language development levels was normal. Receptive language levels were normal in all childs. Expressive language delay was present in childs 3-10. The difference between pre-educational and post-educational receptive language levels was not significant (p=0.140, X2=2.180). Post-educational expressive language levels were significantly higher than pre-educational expressive language levels (p=0.001, X2=10.236) by SUEPL training method. Although language and additional problems were improved by training with the SUEPL-method, some symptoms of APD were not ameliorated by training; and studies for differential diagnosis should continue after training. Conclusion: Our study may help to make differential diagnosis for APD. In children, suspected of APD, tests should be performed before and after training by SUEPL. SUEPL training method causes an improve in "bottom up " processing by increasing input introduce and sound driven. As training is going on in natural life, the childs' understanding rapid or degraded speech also increases. By the help of these clear inputs, acoustic input processing may be improved.Öğe Random gap detection test and random gap detection test-expanded: Results in children with previous language delay in early childhood(Elsevier Sci Ltd, 2011) Muluk, Nuray Bayar; Yalcinkaya, Fulya; Keith, Robert W.Objectives: The children with difficulty in receiving sounds presented at rapid rates in speech sounds and language learning period, may have delay in speech sounds and language development due to hearing speech sounds not clearly. Auditory temporal processing (ATP) is the ability to perceive auditory signals of brief duration accurately when presented at rapid rates. ATP can be evaluated by the random gap detection test (RGDT), which detects a brief gap between two stimuli. In this study, we investigated performance of children with previous language delay (PLD), currently having disorders in more than one speech sounds, on random gap detection test (RGDT) and RGDT-expanded (RGDT-EXP) tests. Methods: 12 children (8 male, 4 female) with previous language delay (PLD) and complaint of expressing speech sounds distorted, were included into the study. They had applied language training for at least one-year period in the past and in the current time, their language development is normal. They expressed one or more speech sounds as distorted. The control group consisted of 10 normal hearing children with normal phonological development and language matched for age; and who had not PLD (5 male, 5 female). Children language levels were evaluated by Preschool Language Scale-4 test; or Clinical evaluation of language fundamentals, fourth edition (CELF-4) according to child's age. Speech sounds development was assessed by Speech Sound Development Test (SSDT). They were applied RGDT and/if necessary, RGDT-EXP. Each child responded whether he/she heard one or two tones. Their responses were taken as verbally and/or hold up one finger or two fingers. In the second test, they were applied speech discrimination test in quiet environment and in noise. Gap detection thresholds (GDTs) were detected at 500-4000 Hz; and Composite GDTs (CGDTs) were found for the study and control groups. GDT/CGDT > 20 ms was considered as abnormal for temporal processing disorder. Results: In the study group with PLD, mean of the GDTs were all over the normal limits; and in control group, mean of GDTs were all in normal limits. The difference between the mean GDTs of the study group were significantly higher than the control groups at all frequencies of 500-4000 Hz. In PLD group, CGDT (103.53 +/- 11.63 ms) was significantly higher than that of the control group, (10.35 +/- 0.65 ms) (p = 0.021). Conclusion: The children with PLD have difficulties in perception of speech sounds at a certain rate, even they have not language learning difficulties. Therefore, difficulty in distinguishing of speech sounds may cause especially receptive language development delay. We believe that perception of the speech sounds and language in a certain speed; and temporally degraded speech programmes should be incorporated into the training programme and may help to prevent delays. (C) 2010 Elsevier Ireland Ltd. All rights reserved.Öğe Speech Sounds Acquisition Evaluated by Speech Sound Development Test (SSDT) in Turkish-Speaking Children(Aves, 2010) Yalcinkaya, Fulya; Muluk, Nuray Bayar; Budak, BilgehanThe aim of this study is to provide normative data regarding the age of consonant-acquisition in normally developing children. A total of 753 children between 1 and 7 years of age were selected from seven different regions throughout Turkey. For 1-year old children, the spontaneous sound expressed (spontaneous speech) was recorded. The Speech Sound Development Test (SSDT) was applied to children within the age-range of 2-7 years old. Classifications of 'acquiring tested sound' and 'completing development' were based on 'pass criteria 75%' and 'criteria 90%', respectively. It was determined that children between 1 and 2 years of age acquired the sounds of /b, d infinity,tf,d,g,gamma,k,l,m,n,p,s, integral,t,j,z/, children at 3 years of age acquired the sounds of /h,f,v/, and children at 4 years of age acquired the sounds of /r,infinity/. However, it was revealed that the development of all sounds was being completed when the children were 5 or 6 years old.Öğe State-Trait Anxiety Inventory (STAI) assessment of mothers with language delayed children(Canadian Soc Clinical Investigation, 2010) Cirpar, Oezden Ciftci; Muluk, Nuray Bayar; Yalcinkaya, Fulya; Arikan, Osman Kuersat; Oguzturk, Omer; Aslan, FilizObjectives: In this study, we evaluated the continuous and state anxiety levels of mothers with children with language delay. Methods: The study group consisted of the mothers of 18 children with language delay. The control group consisted of the mothers of 29 healthy children without language delay. To gain data about mothers, a personal information form and Spielberger's State-Trait Anxiety Inventory (STAI) form were applied to determine continuous and state-trait anxiety levels. Results: State anxiety levels in the study group were significantly higher (by Student t-test) than that of the control group. For continuous anxiety level, no statistically significant difference was determined between two groups. In the study group, higher education levels of mothers and their husbands were associated with lower levels of both continuous and state anxiety. Conclusion: In the majority of the group of mothers with language delayed children and even mothers of children with normal language development, there were high levels concern. Mothers' concerns and anxiety levels may decrease with increasing levels of their education levels. We recommend providing detailed information regarding language development to the families at all stages of the childs' training programme.Öğe Time Course of Auditory Processing, Visual Processing, Language and Speech Processing(Mediterranean Soc Otology & Audiology, 2010) Muluk, Nuray Bayar; Yalcinkaya, FulyaEach stimulus is processed in the brain at a certain speed/time. Hearing, vision and language are included in this process. Such as, the onset of language specific phonetic phonological analysis has been estimated at 100-200 ms. Listener the smaller the gap that can be detected. Such as, rapidly changing (gap) sounds such as /r/, /I/. There are need both short (20msec for phoneme duration signals) and long (200msec for syllable-duration signals) segments of speech. In hearing, language and speech processing functions, brain works together with all fields (auditory processing, memory, language and the image and speech recording area, etc.) synchronizely for seconds as the orchestra. If neurons can not participate this processing synchronizely, synchronization is corrupted. Processing time of information and synchronization work should be the basis for hearing, language and speech training. Phonetics in speech come to our ears in a few seconds through sound waves. If these sounds can not received within a few seconds, they get lost. If received, they were processed in the auditory pathway and brain in a few seconds. The purpose of this review is to draw attention that, if the sounds are received and processed within a few seconds, the training method used in speech training model should be intended for sounds' transmission and processing in a few seconds. In addition, all of the functions (auditory, view processing, memory and language) should be included into training by bottom-up approach. Auditory processing is the ability to listen, comprehend and respond to information that we hear through our auditory channels. It needs decoding of the neural message. Auditory processing involves attention to detection and identification of the signal; and decoding of the neural message. If we don't give full attention to heard things, listening difficulty ocuurs. In poor attention and listening conditions, rapid acoustic changes in speech can not be discriminated.Öğe Transient evoked otoacoustic emissions and contralateral suppressions in children with auditory listening problems(Elsevier Sci Ltd, 2010) Yalcinkaya, Fulya; Tokgoz-Yilmaz, Suna; Muluk, Nuray BayarObjectives: Transient evoked otoacoustic emissions (TEOAEs) are reflections of cochlear energy produced during the processing of sound. The suppression effect identified as the decrease with the additional tone stimulator of the otoacoustic emission amplitude is use for assessing efferent auditory system function. The aim of this study is to investigate the contralateral suppression effect (CSE) of transient evoked otoacoustic emissions (TEOAEs) in children with auditory listening problems (ALPs) compared to normal hearing children. Method: The study group (Group 1) was consisted of 12 ALP children (8 males and 4 females), aged 5-10 years, and associated with receptive and expressive language delay. The control group was consisted of (Group 2) 12 children with normal hearing levels, matched according to gender and age of TEOAEs and CSE of TEOAEs were investigated at 1.0-4.0 kHz in both groups. Results: For right ear, at 1.0 and 3.0 kHz, TEOAE amplitudes of the ALP group were significantly lower than the control group. At 2.0. 4.0 and 5.0 kHz of the right ear and at 1.0-5.0 kHz of the left ear, TEOAE amplitudes were found as not different between ALP and control groups. Suppression values of the ALP group were significantly lower than the control group at 1.0-2.0 kHz of the right ear and at 2.0 kHz of the left ear. At the other frequencies, there was no significant difference between the suppression values of the ALP and control groups. Conclusion: Lower suppression values in ALP group at all frequencies (significant at 1.0-2.0 and 2.0 kHz in the right and left ears, respectively) showed that cochlear and cranial maturation of the ALP group may lower than the control group. Since the age profile in both group is similar, we thought that ages effect on this results is not important. Our results showed that children with ALP have auditory processing difficulties in noisy environment. For understanding the efferent auditory system, patients with auditory processing disorders may be evaluated by the help of background noise. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
