Wii-Habilitation to Enhance Auditory Processing Skills
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Wii-habilitation to Enhance Auditory Processing Skills Wii-habilitation to Enhance Auditory Processing Skills Addie J. Dowell, B.A. Brittany Milligan, B.A. D. Bradley Davis, Au.D. Annette Hurley, Ph.D. Louisiana State University Health Sciences Center New Orleans, Louisiana Auditory training programs are often included as part of the remediation plan for children with (central) auditory processing disorder [(C)APD]. Training improves performance and usually includes formal therapy; however, it may also utilize informal DFWLYLWLHV 7KHVH LQIRUPDO DFWLYLWLHV VSHFL¿FDOO\ WDUJHW GH¿FLW DUHDV RI DXGLWRU\ ZHDNQHVVHV DQG PD\ LQFOXGH ³HGXWDLQPHQW´ activities, such as board games, computer games, or recorded audio books. This brief report will review Wii video games that WDUJHW VSHFL¿F DXGLWRU\ SURFHVVLQJ VNLOOV DXGLWRU\ EOHQGLQJ SURFHVVLQJ VSHHG VKRUWWHUP PHPRU\ HWF DQG ZKLFK PD\ EH XWLOL]HGGXULQJSOD\IRUVSHFL¿FDJHJURXSV7KLVLQIRUPDWLRQFDQEHXVHIXOIRUDXGLRORJLVWVVSHHFKODQJXDJHSDWKRORJLVWVHDUO\ interventionists, or parents who wish to engage listening and auditory processing skills during play. Introduction LQDSRVLWLYHZD\´ 0XVLHN&KHUPDN :HLKLQJS Auditory training activities may be formal or informal. Formal In the past few years, there has been a renewed interest in the therapy activities are often completed in a clinical setting with a diagnosis and treatment of (central) auditory processing disorder professional who has control over the presented stimuli. Formal >&@$3' $ & $3' UHIHUV WR ³GLI¿FXOWLHV LQ WKH SHUFHSWXDO therapy activities may include computer mediated programs, processing of auditory information in the central nervous system localization training, phoneme discrimination training, speech in and the neurobiologic activity that underlies that processing and QRLVHWUDLQLQJRUIUHTXHQF\DQGLQWHQVLW\GLVFULPLQDWLRQWUDLQLQJ gives rise to the electrophysiologic auditory potentials” (ASHA, etc. (Musiek, et al., 2007). 7KLVGLDJQRVLVLVXVXDOO\PDGHE\DTXDOL¿HGDXGLRORJLVW Informal activities may be done at home and are usually after the patient has completed a comprehensive test battery (AAA, recommended to supplement formal training. These activities may $6+$ 7UHDWPHQW RI & $3' JHQHUDOO\ IRFXVHV include computer games, board games, music training, or video RQ WKUHH DUHDV HQYLURQPHQWDO FKDQJHV WR HDVH FRPPXQLFDWLRQ JDPHVWKDWWDUJHWVSHFL¿FDXGLWRU\GH¿FLWDUHDV)RUH[DPSOHWKH GLI¿FXOWLHVLQWURGXFLQJFRPSHQVDWRU\VNLOOVDQGVWUDWHJLHVIRUWKH Simon® game may be useful for temporal processing training and GLVRUGHU DQG UHPHGLDWLRQ RI WKH DXGLWRU\ GH¿FLW $$$ for auditory memory training (Musiek, 2005). This game has four Auditory training is one type of direct remediation of (C)APD. lighted, colored buttons, with a corresponding audible tone when It is known that the brain retains a lifelong capacity for plasticity activated. During play, the buttons will light up in a random pattern. DQG DGDSWLYH UHRUJDQL]DWLRQ 7KHUHIRUH DXGLWRU\ GH¿FLWV RU The player must replicate the pattern. The number of buttons in the ZHDNQHVVHVPD\EHDWOHDVWSDUWLDOO\UHYHUVLEOHWKURXJKDGH¿FLW UDQGRPVHTXHQFHLQFUHDVHVLQOHQJWKDVWKHJDPHFRQWLQXHV VSHFL¿FWUDLQLQJSURJUDP Everyday games and activities can improve auditory $XGLWRU\ WUDLQLQJ SURJUDPV VWUHQJWKHQ VSHFL¿F DXGLWRU\ processing skills in children with (C)APD (Ferre, 2002) and VNLOOV7KHVHLQFOXGHORFDOL]DWLRQDQGODWHUDOL]DWLRQVHTXHQFLQJ should be initiated whenever there is a suspicion of (C)APD of sounds, phoneme/syllable discrimination, auditory memory, (AAA, 2010). Ferre (2002) listed several board games that targeted VRXQGEOHQGLQJIUHTXHQF\DQGLQWHQVLW\GLVFULPLQDWLRQWHPSRUDO VSHFL¿FDXGLWRU\VNLOOVDVGHVFULEHGE\WKH%HOOLV)HUUHSUR¿OHVRI processing training (including temporal ordering, temporal gap (C)APD (Bellis, 2003). (The reader is referred to Bellis, (2003) for detection and discrimination), improving speech discrimination DFRPSUHKHQVLYHGHVFULSWLRQRIWKH%HOOLV)HUUH & $3'SUR¿OHV in noise, and an improvement in interhemispheric transfer of as this is beyond the scope of this report.) A very brief description information (ASHA, 2005). RI WKH %HOOLV)HUUH SUR¿OHV FKDUDFWHULVWLF DXGLWRU\ GH¿FLWV DQG Auditory training relies on plasticity in the central auditory VXJJHVWHGH[DPSOHVRIDFWLYLWLHVIRUDXGLWRU\VSHFL¿FHQULFKPHQW V\VWHPIRU LPSURYHGSHUIRUPDQFH$XGLWRU\WUDLQLQJLVGH¿QHG are provided in Table 1. as, “a set of (acoustic) conditions and/or tasks that are designed Kuster (2009) compiled a list of free listening games and to activate auditory and related systems in such a manner that activities, available on the Internet. This list of activities ranged their neural base and associated auditory behavior are altered in a hierarchy of auditory skills from detection, discrimination, 77 Journal of Educational Audiology vol. 17, 2011 7DEOH Profiles of (central) auditory processing disorder and associated deficits. potential use of Nintendo Wii games as an auditory training tool, for informal (C)APD therapy. Primary Profile Deficits Targeted Skills for Suggested Games & Remediation Activities Method Decoding ƔListening in background noise ƔPhoneme identification ƔRed Light-Green Light ƔSpelling and reading difficulty ƔPhonological ƔTelephone ƔSound/symbol association awareness ƔWheel of Fortune® :H GH¿QHG WKH FULWHULD IRU LQFOXVLRQ LQ WKLV ƔSound discrimination ƔSound discrimination ƔScrabble® report. $JDLQ ZH GH¿QH UHSRUW QRW DV VFKRODUO\ ƔSound blending ƔWord attack skills research project, but as a description of our research Integration ƔCombining multi-modality ƔInterhemispheric ƔScrabble® DFWLYLW\WRIXO¿OORXUFOLQLF¶VQHHG Initially, because information transfer ƔBopit® ƔReading comprehension ƔBinaural skills ƔSimon® of its popularity, we limited our review of video ƔFollowing auditory directions ƔSound localization ƔSimon says ƔAuditory & visual ƔCard games games to the Nintendo Wii format. Secondly, we information reviewed games appropriate for use for children Prosodic ƔUnderstanding the meaning ƔPerception ƔMadGab® over the age of 6 years. Thirdly, the Entertainment ƔComprehending main idea ƔTemporal patterning ƔSinging ƔFrequency & temporal ƔPragmatics ƔDramatic arts Software Rating Board (ESRB) ratings were also discrimination reviewed to ensure appropriate content of the video LGHQWL¿FDWLRQ WR FRPSUHKHQVLRQ 7KH )HUUH ³*DPHV :H game for children. Lastly, we also adopted the Play” and Kuster’s (2009) listening activities are useful resources SRSXODU%HOOLV)HUUHVXESUR¿OHPRGHORI & $3' %HOOLV available to parents of children diagnosed with (C)APD. DV WKH IUDPHZRUN IRU UHYLHZLQJ YLGHR JDPHV WR WDUJHW VSHFL¿F To date, we are unaware of a review of video games that would DXGLWRU\GH¿FLWV,QWKLVPRGHOWKHUHDUHWKUHHSULPDU\ & $3' enhance auditory processing skills. This review will be useful for SUR¿OHV 'HFRGLQJ ,QWHJUDWLRQ DQG 3URVRGLF 7KHVH SUR¿OHV clinicians and parents who wish to enhance auditory processing are based upon an individual’s auditory behavior and (C)APD skills during informal therapy times, outside of the formal therapy behavioral and electrophysiological test results. (See Table 1 for environment. a brief description). The genesis of computer games can be traced back to the early We began our search using popular Internet search engines to 1950s (Kent, 2001). Since this time, these games have evolved locate video gaming manufacturing Web sites, parental information with technology, increased in complexity and sophistication of Web sites, and multinational electronic commerce company Web graphics, narratives, and storylines and have grown in popularity sites (i.e., Amazon.com, GameStop.com) and searched for games RYHUWKHODVW¿YHGHFDGHV .HQW 0DQ\RIWKHHDUO\YLGHR marketed or advertised as ‘educational,’ parent-recommended, JDPHV ZHUH QRW VSHFL¿FDOO\ GHVLJQHG IRU HGXFDWLRQDO SXUSRVHV and/or listed as top-selling video games. We compiled a list of but for “fun.” However, most games promote incidental learning potential video games. as they are built around rule-based strategies, logic, memory, From this list, we researched the video game by reviewing adaptability, and motivation. the game publisher’s synopsis and consulting consumer reviews. During the recent market growth of “edutainment” (education We “sampled” each game by playing a demonstration version on through entertainment), video games and video gaming systems the manufacturer’s Web site, to determine if auditory processing DUH D ¿[WXUH LQ PRVW KRPHV (GXFDWLRQDO YLGHR JDPHV DSSHDO related skills were incorporated in the game. Video games were to young children, as well as their parents, because they make VHOHFWHGLIWKH\WDUJHWHGDWOHDVWWZRVNLOOVRID & $3'VXESUR¿OH learning fun. Some video games are referred to as families. Therefore, we did One popular gaming system that many families have in their not list each individual video game title. For example, Guitar Hero homes is the Nintendo Wii. Since its launch in November, 2006, Family would be inclusive of such games as Guitar Hero I, II, III, the Wii has sold more than 86 million units, with over 41 million in ,9DQG9*XLWDU+HUR:RUOG7RXUDQG*XLWDU+HUR:DUULRUVRI the United States alone, making it the best selling gaming system 5RFN:HGLGQRWWUDFNWKHLQLWLDOQXPEHURIYLGHRJDPHVUHYLHZHG (Sloan, 2011). PDQ\ZHUHTXLFNO\HOLPLQDWHGE\WKHPDWXUH(65%UDWLQJDQGQRW The interactive Wii Nintendo games have received positive appropriate for children. attention for their role in physical and occupational therapy (Deutsch, Borbely, Filler, Huhn, Guarrera-Bowlby, 2008). Results However, there is little information about the use of this popular gaming system