A transdisciplinary protocol evaluating auditory processing disorder (APD) in children using speech and non-speech stimuli and tools for common co-morbidities: time to re-evaluate APD diagnostic criteria

Abstract

Purpose Effective combination of speech and non-speech tests, using pass–fail cut-off criteria consistent with that used to diagnose co-morbidities, in evaluating APD are explored. Method Retrospective- analysis of 80 children, 8 to 12 years-old, undergoing APD assessment. Filtered Words, Auditory Figure Ground 0 dB, Competing Words, Competing Sentences and Time Compressed Sentences from SCAN-3:C battery were used as speech tests and non-speech tests included Dichotic Digits, Gap Detection and Frequency Pattern. Comorbidities evaluated were language impairment, attention-deficit-hyperactivity disorder and impaired manual dexterity, using cut-off ≤ 10th centile in appropriate tools. Results Seventy-three participants (91.25%) were diagnosed with APD (≤ 9th centile in at least two tests) using speech plus non-speech tests. Speech tests alone diagnosed 60 (82%) and additional low linguistic load/non-speech tests helped in identifying the other 13 (18%). Sixty-six participants (82.5%) had APD plus co-morbidities, seven (8.75%) had APD only and the other seven (8.75%) had comorbidities without APD. Conclusions Initial evaluation by SCAN-3 battery followed by non-speech tests if necessary, will reduce test duration and improve child friendliness. Overlap between APD and comorbidities consistent with the literature is achieved if consistent pass/fail cut-off are used. The use of comorbidities to compare APD diagnostic criteria need to be explored.