Abstract
Objectives:In this study, the authors assessed the potential utility of a recently developed questionnaire (Evaluation of Children’s Listening and Processing Skills [ECLiPS]) for supporting the clinical assessment of children referred for auditory processing disorder (APD).Design:A total of 49 children (35 referred for APD assessment and 14 from mainstream schools) were assessed for auditory processing (AP) abilities, cognitive abilities, and symptoms of listening difficulty. Four questionnaires were used to capture the symptoms of listening difficulty from the perspective of parents (ECLiPS and Fisher’s auditory problem checklist), teachers (Teacher’s Evaluation of Auditory Performance), and children, that is, self-report (Listening Inventory for Education). Correlation analyses tested for convergence between the questionnaires and both cognitive and AP measures. Discriminant analyses were performed to determine the best combination of tests for discriminating between typically developing children and children referred for APD.Results:All questionnaires were sensitive to the presence of difficulty, that is, children referred for assessment had significantly more symptoms of listening difficulty than typically developing children. There was, however, no evidence of more listening difficulty in children meeting the diagnostic criteria for APD. Some AP tests were significantly correlated with ECLiPS factors measuring related abilities providing evidence for construct validity. All questionnaires correlated to a greater or lesser extent with the cognitive measures in the study. Discriminant analysis suggested that the best discrimination between groups was achieved using a combination of ECLiPS factors, together with nonverbal Intelligence Quotient (cognitive) and AP measures (i.e., dichotic digits test and frequency pattern test).Conclusions:The ECLiPS was particularly sensitive to cognitive difficulties, an important aspect of many children referred for APD, as well as correlating with some AP measures. It can potentially support the preliminary assessment of children referred for APD.
Highlights
Some children with normal audiometric thresholds and no known etiology, neurological pathology, or other underlying risk factor have disproportionate difficulty processing speech, in noisy conditions
All questionnaires were sensitive to the presence of difficulty, that is, children referred for assessment had significantly more symptoms of listening difficulty than typically developing children
Some auditory processing (AP) tests were significantly correlated with Evaluation of Children’s Listening and Processing Skills (ECLiPS) factors measuring related abilities providing evidence for construct validity
Summary
Some children with normal audiometric thresholds and no known etiology, neurological pathology, or other underlying risk factor have disproportionate difficulty processing speech, in noisy conditions. While there is certainly an auditory component to the difficulties that these children experience (e.g., Moore 2006), it is not clear that their difficulties are auditory in nature because the children often display problems with short-term memory and attention, as well as having poorer language, literacy, and social skills As a consequence, these children represent a significant challenge to clinical practice. The trend, at present, is to recommend assessment by a multidisciplinary team (e.g., American SpeechLanguage Hearing Association [ASHA] 2005; Dawes & Bishop 2009) For another thing, it is not clear what measures should be used in the assessment of the child or what cutoff criteria to apply for establishing a diagnosis of APD (i.e., a clinically significant listening difficulty) (Hind 2006; Dillon et al 2012; Wilson & Arnott 2013). Choice of cutoff criteria for determining diagnosis depends in the clinical context on current recommendations from professional bodies (e.g., ASHA 2005; American Academy of Audiology [AAA] 2010), while in the research context, it will reflect the theoretical position of the researcher and varies across studies (Wilson et al 2011)
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