Abstract
(Central) auditory processing disorder ((C)APD) is a controversial diagnostic category which may be an artefact of referral route. Yet referral route must, to some extent, be influenced by a child’s profile of presenting symptoms. This study tested the hypothesis that parental perception of listening difficulty is associated with weaknesses in ability to sustain attention while listening to speech. Forty-four children (24 with listening difficulties) detected targets embedded in a 16-minute story. The targets were either mispronunciations or nonsense words. Sentence context was modulated to separate out effects due to deficits in language processing from effects due to deficits in attention. Children with listening difficulties missed more targets than children with typical listening abilities. Both groups of children were initially sensitive to sentence context, but this declined over time in the children with listening difficulties. A report-based measure of language abilities captured the majority of variance in a measure capturing time-related changes in sensitivity to context. Overall, the findings suggest parents perceive children to have listening, not language difficulties, because weaknesses in language processing only emerge when stressed by the additional demands associated with attending to, and processing, speech over extended periods of time.
Highlights
Children referred for suspected (Central) Auditory Processing Disorder (APD) present with normal hearing, but have difficulty understanding speech, when there is background noise
Symptoms of inattention, which are more commonly associated with attention deficit hyperactivity disorder (ADHD), have long been noted in APD13, but until recently, any contribution from cognitive influences, like attention or memory, to the difficulties associated with APD have been explicitly excluded by definition[1,2]
Regardless of listening status (LiD or typical listening abilities (TLi)), all participants correctly matched all target words with the corresponding picture/feature in the word recognition task, confirming that the vocabulary used in the continuous listening task was appropriate for both groups of children
Summary
Children referred for suspected (Central) Auditory Processing Disorder (APD) present with normal hearing, but have difficulty understanding speech, when there is background noise. The fact remains, children who are objectively indistinguishable on standardised measures of listening or language follow different referral routes and receive different diagnoses. Despite including the best available candidate tests of auditory processing abilities, the study failed to demonstrate a reliable link between measured thresholds of auditory perception and symptoms of listening, language or reading difficulty. Instead, these symptoms were found to associate more reliably with response inconsistency during testing and the authors hypothesised that APD was a disorder of attention
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