The LISN & Learn auditory training software was developed at NAL by Dr Sharon Cameron and Dr Harvey Dillon. By convolving the speech materials used in the test with head-related transfer functions a three-dimensional auditory environment is produced under headphones. The
software consists of five games - Listening House, Listening Ladder, Answer Alley, Goal Game and Space Maze. The games are played on the child's home computer. Output levels are controlled by the software and presented over headphones.
What is the software designed to remediate?
The software was specifically designed to train children diagnosed with spatial processing disorder (SPD) to hear better in noisy situations, such as the classroom. SPD is a specific type of central auditory processing disorder. Children with SPD are less able than their peers to use binaural cues to selectively attend to sounds coming from one location and suppress noise coming from other locations in the environment. As a result, children with SPD experience greater-than-normal difficulty understanding speech in the presence of background noise. They therefore often report difficulty listening to their teacher’s voice in the classroom setting, where
fluctuating noise levels are commonplace. Thus, if the disorder remains untreated or unmanaged, SPD can interfere with learning at school. SPD is most common in children with a history of prolonged otitis media (or glue ear). SPD is diagnosed with the Listening in Spatialized Noise – Sentences test (LiSN-S).
What does the child have to do?
The child's task is to identify a word from a target sentence. The sentences are spoken by a female speaker and - even though the child is wearing headphones – appear to emanate from 0° azimuth (directly in front of them). The target sentence is presented in background noise -
coming from + and - 90° azimuth (from either side) simultaneously. The background noise consists of looped children's stories spoken by the same female speaker as the target sentences. The child uses his or her computer mouse to select an image which is displayed on the computer screen after the sentence is presented that best matches one of the words in the target sentence.
How does the software work?
A weighted up-down adaptive procedure is used to adjust the signal level of the target sentence based on the child’s response. The target is decreased by 1.5 dB when the child correctly identifies a target image. It is increased by 2.5 dB if the wrong target identified, and it is increased by 1.5 dB if an "unsure" response is made. In this way the child is continually challenged to listen at increasingly difficult signal-to-noise ratios. As both the target sentences and the background stories are all spoken by the same female speaker the child must rely on using the spatial cues embedded in the auditory signals (i.e. differences in the physical location of the speech streams) to differentiate the target sentence from the background noise.
To motivate children they can design an avatar or “buddy” which appears throughout their training program. The child receives “reward coins” for completing games and they can use
their coins to buy items for their buddy in the reward shop or to play non-training reward games. Additional motivational tools and information are provided in the LiSN & Learn FAQs and Additional Resources sections.
How long does the child train for?
The child plays two games per day, five days per week, over a 10 week period, or until 100 games have been completed. Each game takes between 5 to 10 minutes to complete.
What results are expected?
Our studies (Cameron & Dillon, 2011 and Cameron, Glyde and Dillon, in preparation) and clinical trials have shown that the speech reception thresholds of children who train on the LiSN
& Learn for 100 games improve by approximately 10 dB and, following training, they are able to perform on the LiSN-S as well as their peers.
Where do I purchase LiSN & Learn?
To purchase LiSN & Learn auditory training software, click here. Please note that the LiSN & Learn software is designed to be used by one person only, due to the scoring system that is used. Also note that LiSN & Learn software is only designed for use with Windows XP, Vista and 7. It will not run on Mac products.
Research on LiSN & Learn
Cameron and Dillon (2011)
Nine children aged between 6 and 11 years with normal peripheral hearing who were diagnosed with the LiSN-S as having SPD, trained on the LiSN & Learn for fifteen minutes a day five days a week until they had completed 120 games. On average, speech reception thresholds (SRTs) on the LiSN & Learn improved by 10 dB over the course of training. There were significant improvements in post-training performance on the LiSN-S conditions where the target and distracter stimuli are spatially separated, and which specifically evaluate binaural processing ability (p ranging from < 0.003 to 0.0001, η2 ranged from < 0.694 to 0.873). In contrast, there was no improvement on the LiSN-S control conditions where the target and distracter stimuli emanate from the same direction (p ranging from 0.07 to 0.86, η2 ranging from 0.362 to 0.004). Significant improvements were found post-training on measures of memory, one measure of attention and on self-reported ratings of listening ability. There were no significant differences between post- and three-month post-training scores on any of the assessment tools. For all but one of these children these improvements were maintained after a three month period without any further training (Cameron & Dillon, 2011).
Cameron, Glyde and Dillon (in preparation)
Ten children aged 6 to 11 years who were diagnosed with the LISN-S as having SPD were randomly allocated to train with either the LiSN & Learn or another auditory training package for CAPD - Earobics. Both groups trained for approximately 15 minutes per day, five days per week, for 60 sessions. There was a significant improvement on the spatially-separated conditions of the LiSN-S post-training for the LiSN & Learn group (p=0.03 to 0.0008). However, there was no significant improvement in these conditions for the Earobics group (p=0.5 to 0.7). Further, there was no significant improvement found for either group post-training on the control conditions of the LiSN-S where the target and distracters all emanate from the same physical location (0°), with p ranging from 0.9 to 0.3 for the LiSN & Learn group, and 0.8 to 0.6 for the Earobics group.
Group results of post-training listening performance by children, parents and teachers also reflected post- training LiSN-S performance in the two groups. A parent questionnaire (Fisher’s Auditory Problems Checklist) revealed that the listening skills of children in the Listen & Learn group had improved by 31% following training, compared to 8% for the children in the Earobics group. Similarly on a self-reported questionnaire (Listening Inventory For Education or L.I.F.E - Student) the children in the LiSN & Learn group rated their own listening skills as improving by 22% post-training compared to 9% in the Earobics group. Finally, a teacher questionnaire (L.I.F.E. – Teacher) on an incremental scale from -35 to +35 showed a mean post-training rating of 15.8 for the LiSN & Learn group compared to 6.6 for the Earobics group, where 0 is considered “No Change: Benefit of Use Not Identified” and 17 is considered “Support for Positive Change: Use is Beneficial”.
This research has shown that LiSN & Learn training improved binaural processing ability in children diagnosed with SPD, thereby enhancing their ability to understand speech in noise, but that the result is specific to that software and exposure to generalized auditory training programmes will not produce similar outcomes. This study therefore emphasises the importance of deficit-specific remediation to address diagnosed spatial processing deficits.
To see a research poster presentation on these studies click here.