Abstract
Current notions of “hearing impairment,” as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as “Auditory Processing Disorder” (APD) or “Central Auditory Processing Disorder” is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus.
Highlights
Hearing loss (HL), i.e., reduced pure tone sensitivity affects over 5% of the world’s population [1] and is the fifth leading cause of Years Lived with Disability, a component of the Disability-Adjusted Life Year, used to measure the global burden of disease [2]. This hearing impairment, does not include the children and adult individuals who have normal hearing sensitivity but who experience auditory processing difficulties in everyday life that are reflected in reduced performance in other audiometric tests such as speech in noise or complex non-speech sound perception [3]
Auditory processing disorder is defined as a specific deficit in the processing of auditory information along the central auditory nervous system, including bottom-up and top-down neural connectivity [20, 23]
There are cases diagnosed with Auditory Neuropathy Spectrum Disorders (ANSD) at the time of neonatal hearing screening in whom the Auditory Brainstem Responses (ABR) normalize later on [40] and the audiological and clinical profile fulfils Auditory Processing Disorder” (APD) rather than ANSD criteria. This consensus acknowledges the overlap between APD, Hidden Hearing Loss (HHL), and ANSD, which may not always be easy to resolve with current audiological batteries; clinicians should attempt to localize the auditory deficit within the auditory nervous system as best as they can
Summary
Hearing loss (HL), i.e., reduced pure tone sensitivity affects over 5% of the world’s population [1] and is the fifth leading cause of Years Lived with Disability, a component of the Disability-Adjusted Life Year, used to measure the global burden of disease [2] This hearing impairment, does not include the children and adult individuals who have normal hearing sensitivity but who experience auditory processing difficulties in everyday life that are reflected in reduced performance in other audiometric tests such as speech in noise or complex non-speech sound perception [3]. A second aim is to identify issues that future research needs to address in order to further clarify the nature of APD and assist in optimum diagnosis and evidence-based management Authors of this position paper work in European countries and conduct both clinical and research work in the APD field. Five of the authors (DorisEva Bamiou, Martin Ptok, Vasiliki (Vivian) Iliadou, Christiane Kiese-Himmel, and Andreas Nickisch) of this position paper are at the top five publishing APD research while working exclusively in Europe according to the scopus database (United Kingdom, Germany, and Greece)
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