Preliminary evidence comparing three auditory attention network tests in people with aphasia and matched controls

ABSTRACT

Background

The Attention Network Test (ANT) was initially developed to measure three types of attention, alerting attention, orienting attention, and executive control attention, using a single cued-flanker task. Its use has since been extended into the auditory modality where an auditory-spatial ANT revealed that auditory alerting and orienting attention were impaired in people with aphasia (PWA). However, there are a few limitations that may preclude the auditory-spatial ANT from future use with PWA.

Aims

The purpose of this study was to compare the ability of three auditory ANTs to measure alerting attention, orienting attention, and executive control attention in PWA and matched controls, with the final goal being to identify one task to refine in future studies. We hypothesized that all three tasks would measure alerting attention, orienting attention, and executive control attention in the control group. We further expected group differences such that the aphasia group would benefit less from the alerting and orienting cues, and experience greater executive control costs than the control group.

Methods & Procedures

Seventeen PWA and 20 matched controls completed three auditory ANTs. The auditory ANTs used the same cues to measure alerting attention and orienting attention, however they differed on the tasks used to measure executive control attention. Two executive control tasks were pitch discrimination tasks: participants decided if the target word (Auditory Stroop ANT) or tone (Auditory Pitch ANT) was high or low in pitch. The third executive control task was a temporal discrimination task: participants decided if the target tone was short or long in duration (Auditory Duration ANT).

Outcomes & Results

All three auditory ANTs measured executive control attention. However, only the Auditory Pitch and Duration ANTs measured alerting attention and no task measured orienting attention. Group and task also interacted within executive control attention; the Auditory Duration ANT was the only task to meaningfully distinguish the aphasia group’s executive control attention from the control groups’.

Conclusions

Our results suggest that the Auditory Duration ANT may have the greatest clinical utility of the three auditory ANTs trialed. However, further work is needed to optimize the Auditory Duration ANT for clinical use.

KEYWORDS:

• auditory attention
• attention network test
• aphasia
• alerting
• executive control

Acknowledgements

This work was supported by Midwestern University and Purdue University.

Disclosure Statement

The authors report there are no competing interests to declare.

Data availability statement

The data that support the findings of this study are available from the corresponding author (A.L.), upon reasonable request.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02687038.2023.2244168.

Notes

¹ The frequency cue was always valid: A 500 Hz (low) frequency cue was presented prior to stimuli spoken in a low-pitched voice while a 3000 Hz (high) frequency cue was presented prior to stimuli spoken in a high-pitched voice.

² The frequency cue was always valid: A 500 Hz (low) frequency cue was presented prior to a low-pitched target tone while a 3000 Hz (high) frequency cue was presented prior to a high-pitched target tone.

³ The aphasia group made 5.5% of errors on the Auditory Stroop ANT, 12.83% on the Auditory Pitch ANT, and 10.22% on the Auditory Duration ANT. The control group made 1.97% of errors on the Auditory Stroop ANT, 5.21% on the Auditory Pitch ANT, and 2.57% on the Auditory Duration ANT.

⁴ Neutral trials were not specified in the Auditory Pitch or Duration ANT models because they were not programmed into those tasks.