Assessment Of Auditory Processing Disorders Research Articles

Auditory processing disorder: an online survey of hearing healthcare professionals’ knowledge and practices

Objective To investigate (1) the current level of awareness and knowledge on Auditory Processing Disorder (APD) among Audiologists and other hearing healthcare professionals; (2) current practices in screening, diagnosis, and management of APD in children and adults across the UK; (3) professional’s acceptance of APD assessment and diagnosis. Design An online survey was disseminated through the British Academy of Audiology and ENT UK. Study sample A total of 191 hearing healthcare professionals responded to the survey. Results Overall, while 63% of the respondents considered themselves to be adequately informed about APD, only 4% viewed themselves as very informed on the topic. Fewer than half of the respondents report screening (31%), diagnosing (14%), or managing (36%) cases of APD. For screening APD, professionals most commonly use auditory processing tests in adults and take case histories in children, whereas routine audiological procedures are the primary method for diagnosing APD in both adults and children. Although modifying the listening environment is a widely recommended management strategy for APD, half of the respondents indicated that a diagnosis of APD has no implications for patient management. Conclusions There is a critical need to promote APD-related training to ensure they can provide appropriate referrals and management.

Auditory Processing Disorder: Protocols and Controversy.

This study examined current auditory processing disorder (APD) protocols and audiologists' perspectives on the active debate seen in the literature regarding the status of APD as a unique disorder. This study used a cross-sectional, nonexperimental survey design. The participants were 134 U.S. audiologists, representing diversity across experience level and work setting. Popular APD tests from prior surveys remain popular, and a few new tests have emerged. Most audiologists use diverse strategies to identify potential comorbid disorders as part of their APD protocol, including multidisciplinary assessment and referral to other specialists. Most participants disagreed with the assertion that APD is not a unique disorder; however, many also pointed out that patients' struggles with listening need to be the primary focus of APD assessment and management, regardless of the label of the disorder. Qualitative analysis of participant comments on the controversy yielded six themes: Clinical Experience, Comorbidity, Listening Skills, Literature Support, Overdiagnosis, and More Information Needed. Most participants consider APD to be a unique disorder, citing clinical experience and the literature for support; however, many also indicated APD is complicated by comorbidity and APD may be overdiagnosed.

A data-driven approach to identify a rapid screener for auditory processing disorder testing referrals in adults

Hearing thresholds form the gold standard assessment in Audiology clinics. However, ~ 10% of adult patients seeking audiological care for self-perceived hearing deficits have thresholds that are normal. Currently, a diagnostic assessment for auditory processing disorder (APD) remains one of the few viable avenues of further care for this patient population, yet there are no standard guidelines for referrals. Here, we identified tests within the APD testing battery that could provide a rapid screener to inform APD referrals in adults. We first analyzed records from the University of Pittsburgh Medical Center (UPMC) Audiology database to identify adult patients with self-perceived hearing difficulties despite normal audiometric thresholds. We then looked at the patients who were referred for APD testing. We examined test performances, correlational relationships, and classification accuracies. Patients experienced most difficulties within the dichotic domain of testing. Additionally, accuracies calculated from sensitivities and specificities revealed the words-in-noise (WIN), the Random Dichotic Digits Task (RDDT) and Quick Speech in Noise (QuickSIN) tests had the highest classification accuracies. The addition of these tests have the greatest promise as a quick screener during routine audiological assessments to help identify adult patients who may be referred for APD assessment and resulting treatment plans.

Screening for Auditory Processing Disorder in French-Speaking School-Age Children: A Pilot Study

A few clinical screening tools for auditory processing disorder (APD) are currently available. However, most of these tools are in English and cannot be used to screen individuals with a first language other than English. This study aimed to develop an APD screening test battery in French and to assess its psychometric properties in detecting school-age children at risk of APD. Prior to their complete audiological APD assessment, 53 children (7-12 years old) were recruited from an audiology clinic. The APD assessment lasted between 2 and 3 hr, including 15-20 min for the screening test battery. The screening test battery was composed of four behavioral subtests and two questionnaires (parent and teacher). When combined, two among the four behavioral subtests showed a sensitivity of 100% and a specificity of 80%. The newly developed screening tool could help reduce the number of unnecessary APD assessments, therefore allowing early diagnosis in children with APD and increasing their chances of receiving adequate intervention.

Executive functioning skills of children with listening difficulties

AbstractChildren with normal hearing who present with listening difficulties (LiD) are frequently referred for assessment of auditory processing disorder (APD). Complicating diagnosis is the similarities of APD to other neurodevelopmental disorders, especially attention‐deficit hyperactivity disorder (ADHD). Due to well‐documented deficits in executive functioning (EF) in children with ADHD, we hypothesized that a possible root cause of observed listening deficits may be EF deficits, rather than auditory processing alone. For preliminary investigation into this hypothesis, the current study compared EF skills of children with LiD who were referred for APD assessment, with and without a diagnosis of ADHD. EF skills of 24 children between the ages of 7–16 were assessed utilizing the Behavioral Assessment of Dysexecutive Syndrome in Children, and the Behavior Rating Inventory of Executive Function, 2nd edition. Compelling differences were found between groups of children with LiD. Children without ADHD scored lower on measures of inhibitory control compared to children with a diagnosis of ADHD. Decreased EF skills exhibited in children with LiD, even those without a diagnosis of ADHD, support the need for transdisciplinary identification and management of children with LiD.

Lack of a coherent theory limits the diagnostic and prognostic value of the (central) auditory processing disorder: a theoretical and clinical perspective.

To consider pertinent issues towards developing a coherent theory of the auditory processing disorder (APD). By identifying the conceptual and methodological shortcomings that have thwarted development in this area for decades, we propose solutions to achieve a veridical endpoint to advance the field. Concerted efforts in the theoretical, experimental, and clinical domains have focused on validating the APD by demonstrating the " modality specificity " of the deficit. The importance of this conceptual framework is the delineation of auditory-perceptual dysfunctions from more generalized " supra modal" deficits, like those related to attention, memory, and language. Because contemporary schemata have limited the assessment of APD to auditory tasks alone ( unimodal testing), functional dissociations cannot be established, indeterminate diagnoses are problematic, and progress remains unduly constrained. The use of matched tasks in multiple sensory modalities is advocated as a diagnostic imperative to remedy this deficiency. Themes covered by this review include the need to develop a coherent theory of APD, to identify and limit factors which confound a valid diagnosis, and to validate the diagnosis by demonstrating the " modality specificity " of the deficit. Without an obligatory theoretical designation, the APD will remain as an obscure and controversial entity, limited to indeterminate test results and misdiagnoses.

Factor Analysis on Multiple Auditory Processing Assessment–2 and Listening in Spatialized Noise–Sentences Test in Children

Introduction There is need for greater understanding of tests used in assessing all aspects of auditory processing disorder (APD). This is important so that specific deficits can be identified and later remediated with the smallest possible test battery. The American Speech-Language-Hearing Association (ASHA) recommends five areas/domains for behavioral assessment: (a) temporal, (b) binaural (dichotic) separation/integration, (c) monaural low redundancy, (d) binaural interaction/localization/lateralization, and (e) auditory discrimination. Multiple-factor studies support the first three domains, which are most often used for APD assessment and which can be measured in a test battery normed within the United States (Multiple Auditory Processing Assessment-2 [MAPA-2]). This study was designed to determine if factored results from children would clarify whether a behavioral test (Listening in Spatialized Noise-Sentences Test [LiSN-S]) would factor within one of the first three domains or be separate, possibly within the fourth domain, binaural interaction. Method Fifty-one 8- and 9-year-olds with normal development and normal otoscopy and hearing responses bilaterally from 500 to 4000 Hz at 20 dB HL were recruited. Two sets of APD tests were administered: MAPA-2 and LiSN-S. Results Results verified the expected three-factor structure for MAPA-2. LiSN-S did not factor within one of those three, suggesting that some processes involved in the LiSN-S tasks require interactions between the two ears different from those involved in dichotic perception and thus better belong in the ASHA binaural interaction/lateralization domain. Conclusions Auditory processing abilities are sufficiently independent of each other that test batteries spanning the first three ASHA domains are not sensitive to at least some abilities in the fourth domain. This additional factor evidence is helpful. Future research should examine the utility of measuring additional factors within APD in order to achieve the most efficient and comprehensive test battery.

Auditory processing, co-morbidities, and parental report of sleep disturbance in children with auditory processing disorder (APD)

ObjectivesTo evaluate the prevalence of sleep disturbance and its relationship with auditory processing (AP) and co-morbidities in children diagnosed with auditory processing disorder (APD). MethodsData from 109 children (Males = 59, Females = 50) with mean non-verbal intelligence quotient (NVIQ) of 89.44 (SD:18.16), aged between 6 and 16 years (mean: 10 years 7 months; SD: 2 years 9 months) with a diagnosis of APD were analysed. Participants performed ≤1.33 SD below the mean in two or more out of five SCAN-3 diagnostic APD tests that included ‘Filtered Words’ (FW), ‘Auditory Figure Ground 0 dB’ (AFG0), ‘Competing Words-Directed Ear’ (CW-DE), ‘Competing Sentences’ (CS) and ‘Time Compressed Sentences’ (TCS). Concern about sleep in addition to other symptoms and medical history were documented from structured parental history sheet which forms part of the routine APD assessment. Language impairment (LI), attention-deficit-hyperactivity-disorder (ADHD) and oppositional defiant disorder (ODD), and anxiety were evaluated using the ‘Children's Communication Checklist-2’ (CCC-2), ‘Swanson Nolan and Pelham rating scale’ (SNAP-IV) and ‘Anxiety Scale for Children-Autism Spectrum Disorder’ (ASC-ASD) respectively. ResultsSixty children had sleep disturbance, a prevalence of 55% (95% CI 45.2%–64.6%). The two groups of APD children, with (n = 49) and without sleep (n = 60) disturbance, did not vary in their auditory processing abilities. The sleep disturbed group had significant issues with pragmatic language impairment, hyperactivity/impulsivity, oppositional defiant symptoms and anxiety compared to the group without sleep disturbance when they were analysed separately. After the variables were considered in step wise fashion in binary logistic regression analyses, only pragmatic language impairment and anxiety predicted sleep disturbance (p < .01). ConclusionIn APD the prevalence of sleep disturbance is high, justifying screening within a transdisciplinary APD assessment protocol. Sleep disturbance in APD is predicted by pragmatic language impairment and anxiety, but not by ADHD symptoms or ODD.

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

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.

Neuroimaging Techniques in Assessment of Auditory Processing Disorders: A Review

Neuroimaging Techniques in Assessment of Auditory Processing Disorders: A Review

Contribution of Functional MRI in Assessment of Auditory Processing Disorders

Contribution of Functional MRI in Assessment of Auditory Processing Disorders

A Nonsense Consonant-Vowel-Consonant Word Test to Assess Auditory Processing.

Dichotic listening (DL), or how the two ears work together as a team, is often used in the assessment of auditory processing disorders in both children and adults. Currently, the battery of dichotic tests includes stimuli containing words, digits, and nonsense consonant-vowel syllables. Single-syllable nonsense words are of particular use in assessing processing abilities because they can evaluate auditory processing without a listener's dependence on linguistic knowledge. Therefore, nonsense words may assess auditory processes independently of previous vocabulary knowledge. This study is designed to assess the clinical applicability and face validity of a nonsense word DL test in a young adult population. This study included an experimental design to investigate the performance of young adult listeners on a Dichotic Nonsense Word (DNW) test spoken by a male and female speaker. The results were compared with one study that investigated young adult listener's performance on dichotic tests of English words. A total of 100 young adult participants were recruited from the School of Health and Rehabilitation Sciences at the University of Pittsburgh to participate in the study. The participants ranged in age from 20 to 30, with an average age of 23, and all participants had normal hearing. DL performance was measured in all participants using the Dichotic Words Test (DWT) and the newly developed DNW test. Kolmogorov-Smirnoff tests of normality were used to assess distribution of right- and left-ear scores. Criterion cutoff scores were determined for the percent correct scores in the nondominant ear and dominant ear and for ear advantage. Scores were significantly different between the two tests in the right ear, Z = -8.258, p < 0.001, and in the left ear, Z = -8.471, p < 0.001. Scores within each test were higher for the right ear than for the left ear, and scores for both ears were significantly lower on the DNW test than for the DWT. Ear advantage scores from the DNW test were significantly larger than those obtained from the DWT. The low and high 95% criterion cutoff ranges for the DNW test were considerably wider than the 95% criterion cutoff ranges for the DWT. Results indicate that the new DNW test may be a useful clinical tool within a test battery for evaluating auditory processing skills independent of vocabulary knowledge.

The Danish test battery for auditory processing disorder evaluated with patient and control data

Objective: This study evaluates the Danish test battery for auditory processing disorder (APD). The battery consists of four behavioural tests, two speech and two non-speech stimuli tests. The evaluation includes determination of: (1) new cut-off values (pass-fail criteria), (2) the sensitivity and the specificity of the entire test battery and (3) the failure rate of different test combinations.Design: For each test in the battery, cut-off values were determined using the weighted Youden index. Applying the newly derived cut-off values, the distribution of failing specific test combinations was determined.Study sample: A group of 112 children diagnosed with APD (57 boys, 55 girls, aged 6–16 years) and a control group containing 158 children without auditory problems (75 boys, 83 girls, aged 6–16 years).Results: Cut-off values for different weights of the sensitivity and the specificity have been determined. Using the criterion that at least two tests have to be failed for APD to be suspected, the sensitivity and the specificity of the entire test battery were 95.3% and 91.6%, respectively. Some test combinations were found to have higher failure rates than others.Conclusions: Due to the high sensitivity and specificity the test battery has good predictive value in APD assessment.

The Relationship between Types of Attention and Auditory Processing Skills: Reconsidering Auditory Processing Disorder Diagnosis.

Measures of attention have been found to correlate with specific auditory processing tests in samples of children suspected of Auditory Processing Disorder (APD), but these relationships have not been adequately investigated. Despite evidence linking auditory attention and deficits/symptoms of APD, measures of attention are not routinely used in APD diagnostic protocols. The aim of the study was to examine the relationship between auditory and visual attention tests and auditory processing tests in children with APD and to assess whether a proposed diagnostic protocol for APD, including measures of attention, could provide useful information for APD management. A pilot study including 27 children, aged 7–11 years, referred for APD assessment was conducted. The validated test of everyday attention for children, with visual and auditory attention tasks, the listening in spatialized noise sentences test, the children's communication checklist questionnaire and tests from a standard APD diagnostic test battery were administered. Pearson's partial correlation analysis examining the relationship between these tests and Cochrane's Q test analysis comparing proportions of diagnosis under each proposed battery were conducted. Divided auditory and divided auditory-visual attention strongly correlated with the dichotic digits test, r = 0.68, p < 0.05, and r = 0.76, p = 0.01, respectively, in a sample of 20 children with APD diagnosis. The standard APD battery identified a larger proportion of participants as having APD, than an attention battery identified as having Attention Deficits (ADs). The proposed APD battery excluding AD cases did not have a significantly different diagnosis proportion than the standard APD battery. Finally, the newly proposed diagnostic battery, identifying an inattentive subtype of APD, identified five children who would have otherwise been considered not having ADs. The findings show that a subgroup of children with APD demonstrates underlying sustained and divided attention deficits. Attention deficits in children with APD appear to be centred around the auditory modality but further examination of types of attention in both modalities is required. Revising diagnostic criteria to incorporate attention tests and the inattentive type of APD in the test battery, provides additional useful data to clinicians to ensure careful interpretation of APD assessments.

Electrophysiological assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate.

ObjectivesCleft lip and/or palate is a common congenital craniofacial malformation found worldwide. A frequently associated disorder is conductive hearing loss, and this disorder has been thoroughly investigated in children with non-syndromic cleft lip and/or palate (NSCL/P). However, analysis of auditory processing function is rarely reported for this population, although this issue should not be ignored since abnormal auditory cortical structures have been found in populations with cleft disorders. The present study utilized electrophysiological tests to assess the auditory status of a large group of children with NSCL/P, and investigated whether this group had less robust central auditory processing abilities compared to craniofacially normal children.Methods146 children with NSCL/P who had normal peripheral hearing thresholds, and 60 craniofacially normal children aged from 6 to 15 years, were recruited. Electrophysiological tests, including auditory brainstem response (ABR), P1-N1-P2 complex, and P300 component recording, were conducted.ResultsABR and N1 wave latencies were significantly prolonged in children with NSCL/P. An atypical developmental trend was found for long latency potentials in children with cleft compared to control group children. Children with unilateral cleft lip and palate showed a greater level of abnormal results compared with other cleft subgroups, whereas the cleft lip subgroup had the most robust responses for all tests.ConclusionChildren with NSCL/P may have slower than normal neural transmission times between the peripheral auditory nerve and brainstem. Possible delayed development of myelination and synaptogenesis may also influence auditory processing function in this population. Present research outcomes were consistent with previous, smaller sample size, electrophysiological studies on infants and children with cleft lip/palate disorders. In view of the these findings, and reports of educational disadvantage associated with cleft disorders, further research that focuses on the auditory processing abilities of children with cleft lip/palate disorder is warranted.

Use of Questionnaire-Based Measures in the Assessment of Listening Difficulties in School-Aged Children.

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.

A long-term follow-up of children and adolescents referred for assessment of auditory processing disorder

Objective: This study investigated whether young adults (between 18 and 30 years at the time of the project) who were assessed for auditory processing disorder (APD) in childhood (between 7 and 16 years) experience persistence of listening and communication difficulties. Design: Participants completed a mixed methods questionnaire focusing on common areas of complaint in APD and two open-ended questions exploring participants’ past and present experiences with listening and communication difficulties. Study sample: Ninety-seven of the 722 potential participants returned completed questionnaires, of whom 66 had been diagnosed with APD (APD group) at the time of their auditory processing assessment and 31 had not met diagnostic criteria (NAPD group) at that time. Results: Substantial commonality was noted in the reported listening and communication difficulties between the APD and NAPD participants. Volunteered comments aggregated into four major content themes which included: listening and communication difficulties; participants’ sense of self; change; and participation. Members of the APD group reported greater communication difficulty than NAPD group members, irrespective of environmental listening conditions. Conclusions: Young adults with a prior referral for, and in some cases a diagnosis of, APD as children continue to experience auditory processing difficulties across a range of daily situations.

Behavioral assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

ObjectivePeripheral hearing disorders have been frequently described in children with non-syndromic cleft lip and/or palate (NSCL/P). However, auditory processing problems are rarely considered for children with NSCL/P despite their poor academic performance in general compared to their craniofacially normal peers. This study aimed to compare auditory processing skills, using behavioral assessment techniques, in school age children with and without NSCL/P. MethodsOne hundred and forty one Mandarin-speaking children with NSCL/P aged from 6.00 to 15.67 years, and 60 age-matched, craniofacially normal children, were recruited. Standard hearing health tests were conducted to evaluate peripheral hearing. Behavioral auditory processing assessment included adaptive tests of temporal resolution (ATTR), and the Mandarin pediatric lexical tone and disyllabic-word picture identification test in noise (MAPPID-N). ResultsAge effects were found in children with cleft disorder but not in the control group for gap detection thresholds with ATTR narrow band noise in the across-channel stimuli condition, with a significant difference in test performance between the 6 to 8 year group and 12 to 15 year group of children with NSCL/P. For MAPPID-N, the bilateral cleft lip and palate subgroup showed significantly poorer SNR-50% scores than the control group in the condition where speech was spatially separated from noise. Also, the cleft palate participants showed a significantly smaller spatial separation advantage for speech recognition in noise compared to the control group children. ConclusionATTR gap detection test results indicated that maturation for temporal resolution abilities was not achieved in children with NSCL/P until approximately 8 years of age compared to approximately 6 years for craniofacially normal children. For speech recognition in noisy environments, poorer abilities to use timing and intensity cues were found in children with cleft palate and children with bilateral cleft lip and palate compared to craniofacially normal children. Consequently, it is worthwhile to consider the potential for auditory processing disorder in when assessing the auditory status of children with NSCL/P.

The Contribution of Speech-Evoked Cortical Auditory Evoked Potentials to the Diagnosis and Measurement of Intervention Outcomes in Children with Auditory Processing Disorder

Cortical auditory evoked potentials (CAEPs) are included in guidelines for assessment of auditory processing disorder (APD), but their diagnostic value and their use as a measure of treatment effectiveness have not been fully explored. The current study has three main aims: (1) to assess if there are differences in CAEPs recorded in quiet and in noise in children with APD compared to a control group of typically developing (TD) children, (2) to investigate the test-retest reliability of CAEPs, and (3) to determine whether participation in discrimination or language with or without support of personal frequency modulation (FM) resulted in significant changes in auditory function as measured by CAEPs. Fifty-five children with APD and 22 TD children age 7 to 13 years participated. There were group differences between TD children and children with APD for CAEP P1 and N250 amplitudes. CAEPs assessed on two occasions (separated by 7 to 10 days) showed a significant reduction in N250 amplitude on the second visit, highlighting the importance of establishing a stable baseline for CAEPs to more clearly delineate the effects of training from other factors influencing measurements. Participants with APD were randomly assigned to five treatment groups, including a no training group, two groups receiving discrimination training (one of these also used personal FM), and two groups receiving language training (one of these also used personal FM). N250 amplitudes changed during the baseline period, in the absence of any specific training, and hence a control group alone is insufficient for establishing intervention effectiveness; establishing a stable pretraining baseline for electrophysiological (and other) outcome measurements is also important. After 6 weeks training, children with APD in the discrimination treatment group showed a further significant change in N250 amplitudes, beyond the change that occurred during the baseline period. These results are limited by the small numbers of participants in each treatment group; however, the finding of some CAEP changes after training is consistent with published evidence for cortical changes after short-term auditory training.

Assessment of auditory processing disorder in children using an adaptive filtered speech test

Objective: One type of test commonly used to assess auditory processing disorder (APD) is the ‘filtered words test’ (FWT), in which a monaural, low-redundancy speech sample is distorted by using filtering to modify its frequency content. One limitation of the various existing FWTs is that they are performed using a constant level of low-pass filtering, making them prone to ceiling and floor effects that compromise their efficiency and accuracy. A recently developed computer-based test, the University of Canterbury Adaptive Speech Test- Filtered Words (UCAST-FW), uses an adaptive procedure intended to improve the efficiency and sensitivity of the test over its constant-level counterparts. Design: The UCAST-FW was administered to school-aged children to investigate the ability of the test to distinguish between children with and without APD. Study sample: Fifteen children aged 7–13 diagnosed with APD, and an aged-matched control group of 10 children with no history of listening difficulties. Results: Data obtained demonstrates a significant difference between the UCAST-FW results obtained by children with APD and those with normal auditory processing. Conclusions: These findings provide evidence that the UCAST-FW may discriminate between children with and without APD with greater sensitivity than its constant-level counterparts.