Central Auditory Processing Tests Research Articles

A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis.

Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.

Assessment of Central Auditory Processing in Children Using a Novel Tablet-Based Platform: Application for Low- and Middle-Income Countries.

Evaluate whether a portable, tablet-based central auditory processing (CAP) test system using native language training videos and administered by minimally trained community health workers can produce CAP results comparable to previously published norms. Our secondary aim was to determine subject parameters that influence test results. Cross-sectional study. Community-based settings in Chontales, Nicaragua, New Hampshire, and Florida. English- and/or Spanish-speaking children and adolescents (n = 245; average age, 12.20 yr; range, 6-18 yr). Completion of the following tests with responses comparable to published norms: Pure-tone average (PTA), gap detection threshold (GDT), fixed-level frequency threshold, masking level difference (MLD), Hearing in Noise Test (HINT), Dichotic Digits Test (DDT), and Frequency Pattern Recognition (FPR) test. GDT, HINT, and DDT had comparable results to previously published normative values. MLD and FPR results differed compared with previously published normative values. Most CAP tests (MLD, GDT, HINT) results were independent of age and PTA (p = 0.1-0.9). However, DDT was associated with age and PTA (p < 0.0001). Pediatric CAP testing can be successfully completed in remote low- and middle- income country environments using a tablet-based platform without the presence of an audiologist. Performance on DDT improved with age but deteriorated with hearing loss. Further investigation is warranted to assess the variability of FPR.

Behavioral Assessment of Central Auditory Processing in Turner Syndrome.

Introduction Turner syndrome (TS) affects ∼ 1 in 2,500 live births. The presence of hearing alterations is one of the comorbidities found in this syndrome. Objective The present study aimed to evaluate the central auditory abilities in TS and to associate the alterations found with the cytogenetic pattern of the syndrome. Methods We included children and adults aged 9 to 39 years old, diagnosed with TS, with numerical or structural alterations of sex chromosomes in their karyotype. A battery of behavioral tests of central auditory processing (CAP) was performed, including a test within the modalities: monoaural low-redundancy, dichotic listening, binaural interaction, and temporal processing (resolution and ordering). We studied auditory skills in the total sample and in the sample stratified by age, divided into groups: G1 (9 to 13 years old), G2 (14 to 19 years old), and G3 (20 to 31 years old). For the association of the cytogenetic pattern, the division was T1 (chromosome monosomy X), and T2 (other TS cytogenetic patterns). Statistical analysis presented data expressed as median and interquartile range for numerical data and as frequency and percentage for categorical data. Results We found alterations in four auditory skills in the three age groups, but there was a statistically significant difference between the age groups only in the Gaps in Noise Test (GIN) ( p -value = 0.009). Regarding karyotype, a greater number of alterations in the T1 cytogenetic pattern (chromosome monosomy X) was observed in four auditory skills, but without a statistically significant difference. Conclusion The alterations found point to an impairment in CAP in TS.

The Relationship between P300 and Central Auditory Processing Test Result.

Central auditory processing (CAP) refers to the perceptual processing of auditory inputs in the central nervous system and includes a series of auditory skills such as sound localization, auditory pattern recognition, and temporal sequencing which is a component of temporal processing. This skill can be assessed by frequency pattern test (FPT) and duration pattern test (DPT). Auditory attention is another skill that contributes to the CAP and can be analyzed by the P300. This study assesses the relationship between the P300 latency and the CAP test results of individuals with normal hearing. An experimental study was used in which the determined tests were applied to the participants. Thirty-four individuals with normal hearing between the ages of 20 and 40 years were included in the study. P300, FPT, and DPT were applied to the participants. The Spearman correlation test and Mann-Whitney U test were used for analysis. There were significant moderate and strong-level negative correlations between P300 latency and the scores obtained from frequency pattern and DPT (p < 0.01). We also analyzed whether P300 latency and frequency pattern and DPT scores differed according to gender and, as a result, did not find significant relationship (p > 0.05). We observed that frequency pattern and DPT scores decreased as P300 latency increased. We propose that these results could contribute to the diagnosis and follow-up process of CAP disorder by allowing P300 and CAP tests to be cross-checked.

Effect of central auditory processing disorders on contralateral routing of offside signals (CROS) hearing aids performance

Objectives The aim of this study was to assess central auditory processing (CAP) tests in patients with single sided deafness (SSD)and to study the effect of central auditory processing disorders(CAPD) on the contralateral routing of signal (CROS) hearing aid performance in these subjects. Design This case-control study was performed in Audiovestibular unit, ENT Department. The study included 20 children with SSD and 20 healthy control children. All participants were subjected to CAP tests including pitch pattern sequence (PPS), gap in noise (GIN) and speech intelligibility in noise (SPIN) tests. The child was fitted with CROS and evaluated by SPIN test and bern benefit in single - sided deafness (BBSS) questionnaire. Results There were lower SPIN, PPS, and GIN total correct scores in children with SSD than the control group. The group with normal central test battery has higher SPIN score and significant performance with questionnaire when fitted with CROS. Conclusions Children with normal central auditory processing test battery performed better when fitted with CROS than those with abnormal test battery.

AudBility: an online program for central auditory processing screening in school-aged children from 6 to 8 years old.

To analyze the performance of students aged between in an auditory skills screening software program, considering the influence of biological determinants and the correlation of auditory tasks with the behavioral assessment tests of central auditory processing (PAC), as well as to present the cutoff points of the battery. In the first stage, the sample consisted of 96 students with typical development, who underwent hearing screening at school. A self-perception questionnaire and the auditory tasks of sound localization (SL), temporal resolution (TR), temporal ordering of frequency (OT-F) and duration (OT-D), auditory closure (AC), dichotic digit- binaural integration (DD) and figure-ground (FG) were applied. Of these, 66 children participated in the second stage of the study, including basic and behavioral audiological assessment from PAC. The gender variable influenced the DD task to the right ear. Age influenced the outcome of five auditory tasks. The right ear performed better in the DD and OT-F tasks. At the age between 6 and 7 years, there was a correlation between screening and diagnosis in the tasks of AC, TR, DD, FG, and OT-F. At the age of 8 years, there was a correlation in the DD and OT-F tasks. The pass/fail criteria varied according to the task and biological determinants. There was a correlation between screening and diagnosis in a greater number of tasks in the age group between 6 and 7 years. The cut-off points for the auditory tasks should be analyzed according to age, sex and/or ear side.

Habilidades auditivas em adultos jovens com e sem percepção de zumbido: um estudo de comparações

ABSTRACT Purpose Objective: To analyze auditory information processing responses in young adult subjects with tinnitus disorder. Methods A descriptive and quantitative study was conducted, involving 36 subjects aged between 19 and 35 years. The subjects were divided into two groups: Group 1 (20 subjects with chronic tinnitus) and Group 2 (16 subjects without tinnitus). All participants underwent medical history assessment, Visual Inspection of the External Auditory Canal, Pure-Tone Audiometry, Speech Audiometry, Acoustic Immittance Measures, and used Behavioral Central Auditory Processing Tests as an evaluation tool - Dichotic Digits Test (TDD), Frequency Pattern Test, Speech in Noise, Masking Level Difference, and Gap in Noise (GIN). Results Statistically significant differences were found between the groups for TDD responses in the left ear and for GIN in both ears. Conclusion Young adults with chronic tinnitus exhibit impairments in binaural integration and temporal resolution skills.

Construction and Standardization of the Syrian Version of the Word Recognition Test for Children with Hearing Impairment

Background and Aim: This study aimed to construct and validate the test material of speech recognition test for children. Such a material helps in conducting the speech tests for native Arab children with Syrian accent. This work is a part of a complete project on preparing and validating the necessary materials for speech and central auditory processing tests for the Arabic Syrian community. Methods: In this cross-sectional comparative study, two sets of phonetically balanced monosyllabic word lists were constructed. The two selected 25-monosyllabic word lists were presented to 50 normal hearing participants with the age range of 5 to 10 years. Tests of validity and reliability were conducted to assure the suitability of this material for the word recognition test. The test was repeated for the same children after three weeks. Results: The two word lists have shown high face and content validity, Cronbach`s alpha coefficient was 0.79, 0.85 for the two lists respectively. Factor validity has shown that the test materials are one-dimensional, the first factor achieved 57.25 and 53.13 of the variance. Test- retest reliability (p&lt;0.001) and Intraclass Correlation Coefficients reliability (p&lt;0.001) were also significant. Conclusion: The data analysis shows that the Syrian version of the word recognition test has high degree of validity and reliability. Therefore, developing the Syrian version of the scale has good psychometric properties, which makes it appropriate for the local use. Keywords: Speech discrimination test; monosyllabic; arabic; syrian accent

WYNIKI OBSERWACJI PACJENTÓW Z NEUROFIBROMATOZĄ TYPU 1 PO FORMALNYM TRENINGU SŁUCHOWYM

BackgroundThe aim was to electrophysiologically evaluate changes in the peripheral and central auditory systems in individuals with neurofibromatosis type 1 who underwent formal auditory training.Material and methodsThe sample consisted of 6 individuals aged between 9 and 15 years. The procedures involved anamnesis, meatoscopy, brainstem auditory potentials and long-latency evoked potentials, and behavioral tests of central auditory processing. All individuals were given 9 weekly sessions of formal auditory training.ResultsAfter therapeutic intervention we observed improved performance in auditory closure (&lt;i&gt;p&lt;/i&gt; = 0.014) and figure–background discrimination for verbal sounds (&lt;i&gt;p&lt;/i&gt; = 0.025). There were no significant changes in brainstem auditory evoked potentials. However, the P300 of the longlatency auditory evoked potential showed significant differences for the left ear in terms of latencies of waves N2 (&lt;i&gt;p&lt;/i&gt; = 0.05) and P3 (&lt;i&gt;p&lt;/i&gt; = 0.05) and the amplitude of N2–P3 (&lt;i&gt;p&lt;/i&gt; = 0.05).ConclusionsTherapeutic intervention by means of formal auditory training is effective in rehabilitating central auditory processing disorder. There were improved responses in both behavioral and electrophysiological assessments, which were maintained for at least 4 months.

Auditory and language skills in children with cleft lip and palate

Objectivesto investigate auditory and language skills in children with repaired cleft lip and palate. MethodsThe sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). ResultsThe central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. ConclusionThere was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Auditory Processing Skills in Patients with Multiple Sclerosis

Background and Aim: Multiple sclerosis (MS) is neurological disease of the central nervous system. Central auditory nervous system can also be affected by MS. The present study aimed to evaluate monaural and binaural auditory processing in patients with MS. Methods: This cross-sectional study was conducted on 45 patients with MS and 45 normal peers as controls aged 25–45 years. They underwent a central auditory processing test battery including the Persian versions of Buffalo model questionnaire (BMQ), staggered spondee word (SSW) test, quick speech in noise test (QSIN), phonemic synthesis test (PST), and two- pair dichotic digit test (DDT). Results: The results of SSW test, QSIN test, PST, DDT and BMQ in the MS group were significantly different than in the control group (p≤0.001). The results showed the poor performance of patients compared to controls in some monaural and binaural auditory processing skills. Conclusion: Central auditory processing disorder is common among patients with MS. The BMQ is a suitable screening tool for identifying affected people. Dichotic listening skills, phonemic processing and speech perception in noise are impaired in MS patients which can have significant impacts on their quality of life. Keywords: Auditory processing; multiple sclerosis, central auditory nervous system; adults; speech perception

Central Auditory Functions of Alzheimer's Disease and Its Preclinical Stages: A Systematic Review and Meta-Analysis.

In 2020, 55 million people worldwide were living with dementia, and this number is projected to reach 139 million in 2050. However, approximately 75% of people living with dementia have not received a formal diagnosis. Hence, they do not have access to treatment and care. Without effective treatment in the foreseeable future, it is essential to focus on modifiable risk factors and early intervention. Central auditory processing is impaired in people diagnosed with Alzheimer’s disease (AD) and its preclinical stages and may manifest many years before clinical diagnosis. This study systematically reviewed central auditory processing function in AD and its preclinical stages using behavioural central auditory processing tests. Eleven studies met the full inclusion criteria, and seven were included in the meta-analyses. The results revealed that those with mild cognitive impairment perform significantly worse than healthy controls within channel adaptive tests of temporal response (ATTR), time-compressed speech test (TCS), Dichotic Digits Test (DDT), Dichotic Sentence Identification (DSI), Speech in Noise (SPIN), and Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) central auditory processing tests. In addition, this analysis indicates that participants with AD performed significantly worse than healthy controls in DDT, DSI, and SSI-ICM tasks. Clinical implications are discussed in detail.

Frequency-Following Response e Potencial Evocado Auditivo de Média Latência: uma análise frente ao processamento auditivo central de jovens adultos

ABSTRACT Purpose: to compare the latency and amplitude of the Frequency-Following Response and the Auditory Middle Latency Response in typical individuals and those with altered auditory abilities, as well as to investigate the sensitivity and specificity of both assessments in relation to central auditory processing. Methods: 32 individuals of both sexes were distributed into Group 1 (without altered auditory abilities) and Group 2 (with altered auditory abilities). The groups were divided according to behavioral tests of central auditory processing. Individuals in both groups underwent auditory evoked potentials. Student’s t-test was used for analysis, considering a 5% significance. Results: in Group 2, V and A had higher latency and lower amplitude and slope. Group 2 also had lower Na and Pa amplitudes in waves A1C3 and A2C3. The Frequency-Following Response showed 93% sensitivity and specificity, while the Auditory Middle Latency Response showed 87% sensitivity and 93% specificity. Conclusion: the individuals presented with altered hearing abilities showed higher latency and lower response amplitude in the Frequency Following Response and Auditory Middle Latency Response compared to typical individuals. The Frequency- Following Response showed a better balance of sensitivity and specificity.

Central auditory processing in children after traumatic brain injury

IntroductionTraumatic brain injury can impair the central auditory pathways and auditory cortex. Hence, individuals who suffered a traumatic brain injury may be at risk of central auditory processing disorders, which can be identified with behavioral tests that assess central auditory function. ObjectiveTo characterize and compare the performance of children and adolescents with and without a history of traumatic brain injury in behavioral tests that assess central auditory processing. MethodThe sample comprised 8- to 18-year-old individuals of both sexes who suffered moderate or severe closed traumatic brain injury 3 to 24 months before their participation in the study and whose hearing thresholds were normal. These individuals were matched for sex and age with other subjects without a history of traumatic brain injury and submitted to behavioral assessment of the central auditory processing with special tests to assess hearing skills (namely, auditory closure, figure-ground, and temporal processing), selected according to their chronological age and response-ability. ResultsThe study group performed statistically worse than the comparison group in auditory closure, figure-ground in verbal dichotic listening, and temporal ordering. The central auditory processing tests with abnormal results in the comparison group were different from those in the study group. ConclusionCentral auditory processing disorders were identified in all subjects of the study group, especially involving auditory closure and temporal processing skills, in comparison with subjects without a history of traumatic brain injury.

Evaluation of temporal processing skills in individuals with normal hearing

Objective: In a cumulative perspective, the aim of this study is to perform Frequency Pattern Test (FPT), Duration Pattern Test (DPT) and Gap In Noise (GIN) Test in order to determine descriptive values of these tests to evaluate central auditory processing on the individuals’ with normal hearing. Material and Methods: A total of 52 participants, as of 28 women and 24 men, with normal hearing, within the age range of 20 to 55 were included in the study. Otoscopic examination, pure tone audiometry and FPT, DPT GIN Test which are central auditory processing tests, were performed on the participants who meet the criteria of the study and voluntarily agreed to participate in the study. Results: Descriptive values were obtained as an average of 78% in FPT, 92.11% in DPT, an average of 61.22% in GIN Test and an average of 6.34 ms in Gap Detection Threshold Conclusions: It is thought that the obtained descriptive values will contribute to the clinics and the literature. Keywords: Auditory temporal tests, central auditory processing, duration pattern test, frequency pattern test, gap in noise test

Changes of Temporal Processing and Hearing in Noise after Use of a Monoaural Hearing Aid in Patients with Sensorineural Hearing Loss: A Preliminary Study.

Background and ObjectivesThe relationship between hearing aid (HA) use and improvement in cognitive function is not fully known. This study aimed to determine whether HAs could recover temporal resolution or hearing in noise functions.Materials and MethodsWe designed a prospective study with two groups: HA users and controls. Patients older than 45 years, with a pure tone average threshold of worse than 40 dB and a speech discrimination score better than 60% in both ears were eligible. Central auditory processing tests and hearing in noise tests (HINTs) were evaluated at the beginning of the study and 1, 3, 6, and 12 months after the use of a monaural HA in the HA group compared to the control group. The changes in the evaluation parameters were statistically analyzed using the linear mixed model.ResultsA total of 26 participants (13 in the HA and 13 in the control group) were included in this study. The frequency (p<0.01) and duration test (p=0.02) scores showed significant improvements in the HA group after 1 year, while the HINT scores showed no significant change.ConclusionsAfter using an HA for one year, patients performed better on temporal resolution tests. No improvement was documented with regard to hearing in noise.

Electrophysiological and behavioral evaluation of auditory processing before and after speech therapy intervention in children after traumatic brain injury: Case reports

Objectives: to verify the effects of a speech therapy intervention program in children after moderate and severe traumatic brain injury using electrophysiological and behavioral assessment of central auditory processing. Method: Five children aged 9 to 11 years old who suffered closed brain trauma of moderate or severe degree for at least 6 months, right-handed, literate before the injury, diagnosed with Central Auditory Processing and Reading and Writing Disorders. Ten speech therapy intervention sessions were held, covering the area of language and auditory training activities. Children were submitted to electrophysiological evaluation with Long Latency Auditory Evoked Potential and behavioral assessment of central auditory processing, pre and post intervention. Results: Statistically significant, after speech therapy intervention, in the LLAEP with tone burst, there was an improvement in the latencies of the N2 component in both ears and P3 in the right ear. CAPD improves the memory test for verbal sounds in sequence and the speech test with white noise in the right ear. Conclusion: After the speech therapy intervention program in individuals with TBI it was observed: reduction of the latency of the N1 component in the left ear, in the LLAEP with tone burst; reduction of the latencies of the components N1, P2 and N2 in the right and left ears, and for the latency of the P3 only in the right ear, in the LLAEP with complex stimuli and performance improvement in the behavioral tests of central auditory memory processing for verbal sounds in sequence and speech with white noise.

Auditory and language skills in children with cleft lip and palate

Objectivesto investigate auditory and language skills in children with repaired cleft lip and palate. MethodsThe sample was composed of 22 children registered at the hospital where the study was conducted, seven to nine years old, 50% being female, with repaired unilateral cleft lip and palate (right or left), without associated malformations. Auditory skills were assessed using four central auditory processing tests: Random Gap Detection Test, Dichotic Digit Test, Dichotic Non-Verbal Test, Sustained Auditory Attention Ability Test. Language performance was evaluated by four standardized instruments: Illinois Psycholinguistic Skills Test, Peabody Picture Vocabulary Test, Token Test and Phonological Skills Profile. The association between auditory and language skills was evaluated by the Fisher exact test at a significance level of 5% (p<.05). ResultsThe central auditory processing tests evidenced that only one child presented adequate performance in all skills analysed, five children presented impaired performance in all skills, and 16 exhibited deteriorations in one to three auditory skills, highlighting that temporal resolution was the most impaired skill (81%). Concerning language, three children presented adequate performance in all tests applied, and Visual Association and Auditory Association were the most impaired skills (40%). No association was observed between deteriorations in auditory and language skills. ConclusionThere was high occurrence of impairment of auditory skills, which compose the central auditory processing, as well as of language skills, with greatest impairment of receptive language.

Masking Level Difference: Performance of School Children Aged 7–12 Years

Background and ObjectivesIn masking level difference (MLD), the masked detection threshold for a signal is determined as a function of the relative interaural differences between the signal and the masker. Study 1 analyzed the results of school-aged children with good school performance in the MLD test, and study 2 compared their results with those of a group of children with poor academic performance.Subjects and MethodsStudy 1 was conducted with 47 school-aged children with good academic performance (GI) and study 2 was carried out with 32 school-aged children with poor academic performance (GII). The inclusion criteria adopted for both studies were hearing thresholds within normal limits in basic audiological evaluation. Study 1 also considered normal performance in the central auditory processing test battery and absence of auditory complaints and/or of attention, language or speech issues. The MLD test was administered with a pure pulsatile tone of 500 Hz, in a binaural mode and intensity of 50 dBSL, using a CD player and audiometer.ResultsIn study 1, no significant correlation was observed, considering the influence of the variables age and sex in relation to the results obtained in homophase (SoNo), antiphase (SπNo) and MLD threshold conditions. The final mean MLD threshold was 13.66 dB. In study 2, the variables did not influence the test performance either. There was a significant difference between test results in SπNo conditions of the two groups, while no differences were found both in SoNo conditions and the final result of MLD.ConclusionsIn study 1, the cut-off criterion of school-aged children in the MLD test was 9.3 dB. The variables (sex and age) did not interfere with the MLD results. In study 2, school performance did not differ in the MLD results. GII group showed inferior results than GI group, only in SπNo condition.

Simplified assessment of central auditory processing in individuals presented with trisomy 21

ABSTRACT Purpose: to analyze the performance of individuals with trisomy 21 (T21) in the simplified assessment of central auditory processing, identify the impaired skills, and compare it with the results of the hearing self-perception questionnaire administered to the parents. Methods: a descriptive, observational, quantitative study conducted at the Speech-Language-Hearing Teaching Clinic of a public university. The sample comprised 16 individuals with T21, aged 8 to 33 years. Simplified assessment tests of central auditory processing were conducted, namely, sounds localization and sequential memory for verbal and nonverbal sounds, diotically. Then, the Scale of Auditory Behaviors (SAB) was administered to the subjects’ parents/guardians. The descriptive statistical analysis with the chi-square test considered p&lt;0.05. Results: in the simplified assessment, 81.3% had abnormal results in the memory tests for verbal sounds; 75%, in the memory tests for nonverbal sounds; and 37.5%, in the sound localization test. In the Scale of Auditory Behaviors, 62.5% of the answers indicated changes in the central auditory processing, demonstrating that the scale can be useful to identify such changes. However, there was no significant association between the questionnaire and the behavioral test results. Conclusion: the results point to impaired sequential memory skills for verbal and nonverbal sounds in most individuals assessed. The simplified assessment results indicate the need for assessments of central auditory processing. Hence, the simplified assessment is highly important to detect possible changes in the central auditory processing that might interfere with the communication and overall learning of individuals presented with trisomy 21.