scholarly journals Combination of Comorbidities as a Reference Standard for Evaluating Auditory Processing Disorder: Response to the Letter to the Editor From Schow et al. (2021)

2021 ◽  
pp. 1-4
Author(s):  
Ansar U. Ahmmed
Keyword(s):  
Sensitivity And Specificity ◽  
Language Impairment ◽  
Visual Processing ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Evidence Based ◽  
Reference Standard ◽  
Research Domain Criteria ◽  
Low Sensitivity ◽  
Research Domain

Purpose Concerns expressed by Schow et al. (2021) around the evidence-based diagnostic criteria suggested by Ahmmed (2021a) are addressed here. The use of combination of comorbidities as a reference standard for evaluating auditory processing tests is a valid strategy, consistent with the Research Domain Criteria framework from the National Institute of Mental Health as well as the Standards for Reporting of Diagnostic Accuracy Studies. The correlations between auditory processing tests and some comorbidities in Ahmmed (2021a) were significant at p < .01. The low sensitivity and specificity reported was not to be related to the principle of using comorbidities as a reference standard but due to the choice of comorbidities combined in the reference standard. Ahmmed (2021a) suggested the option of inclusion of other comorbidities in addition to language impairment and impaired manual dexterity in the reference standard. Visual processing impairment could be considered as the additional comorbidity to improve sensitivity and specificity of the approach suggested by Ahmmed (2021a).

scholarly journals Perception of Small Frequency Differences in Children with Auditory Processing Disorder or Specific Language Impairment

2016 ◽  
Vol 27 (06) ◽  
pp. 489-497 ◽  
Author(s):  
Christine Rota-Donahue ◽  
Richard G. Schwartz ◽  
Valerie Shafer ◽  
Elyse S. Sussman
Keyword(s):  
Language Impairment ◽  
Specific Language Impairment ◽  
Auditory Processing ◽  
Language Skills ◽  
Frequency Discrimination ◽  
Auditory Processing Disorder ◽  
Sensitivity Index ◽  
Small Frequency ◽  
Discrimination Ability ◽  
Frequency Changes

Background: Frequency discrimination is often impaired in children developing language atypically. However, findings in the detection of small frequency changes in these children are conflicting. Previous studies on children’s auditory perceptual abilities usually involved establishing differential sensitivity thresholds in sample populations who were not tested for auditory deficits. To date, there are no data comparing suprathreshold frequency discrimination ability in children tested for both auditory processing and language skills. Purpose: : This study examined the perception of small frequency differences (Δf) in children with auditory processing disorder (APD) and/or specific language impairment (SLI). The aim was to determine whether children with APD and children with SLI showed differences in their behavioral responses to frequency changes. Results were expected to identify different degrees of impairment and shed some light on the auditory perceptual overlap between pediatric APD and SLI. Research Design: An experimental group design using a two-alternative forced-choice procedure was used to determine frequency discrimination ability for three magnitudes of Δf from the 1000-Hz base frequency. Study Sample: Thirty children between 10 years of age and 12 years, 11 months of age: 17 children with APD and/or SLI, and 13 typically developing (TD) peers participated. The clinical groups included four children with APD only, four children with SLI only, and nine children with both APD and SLI. Data Collection and Analysis: Behavioral data collected using headphone delivery were analyzed using the sensitivity index d′, calculated for three Δf was 2%, 5%, and 15% of the base frequency or 20, 50, and 150 Hz. Correlations between the dependent variable d′ and the independent variables measuring auditory processing and language skills were also obtained. A stepwise regression analysis was then performed. Results: TD children and children with APD and/or SLI differed in the detection of small-tone Δf. In addition, APD or SLI status affected behavioral results differently. Comparisons between auditory processing test scores or language test scores and the sensitivity index d′ showed different strengths of correlation based on the magnitudes of the Δf. Auditory processing scores showed stronger correlation to the sensitivity index d′ for the small Δf, while language scores showed stronger correlation to the sensitivity index d′ for the large Δf. Conclusion: Although children with APD and/or SLI have difficulty with behavioral frequency discrimination, this difficulty may stem from two different levels: a basic auditory level for children with APD and a higher language processing level for children with SLI; the frequency discrimination performance seemed to be affected by the labeling demands of the same versus different frequency discrimination task for the children with SLI.

scholarly journals Comment on Ahmmed (2021): The Search for Evidence-Based Auditory Processing Disorder Diagnostic Criteria

2021 ◽  
pp. 1-3
Author(s):  
Ronald L. Schow ◽  
Harvey Dillon ◽  
J. Anthony Seikel
Keyword(s):  
Diagnostic Criteria ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Evidence Based

Purpose Ahmmed (2021) presented a study to advance the goal of an evidence-based diagnostic criteria for auditory processing disorder. We offer some cautions about the interpretation of these results, as well as suggestions for future strategies for developing evidence-based criteria for auditory processing disorder.

Toward Evidence-Based Practice in the Auditory Processing Disorder Clinic

2008 ◽  
Vol 4 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Patti M. Johnstone
Keyword(s):  
Decision Making ◽  
Population Health ◽  
Auditory Processing ◽  
Clinical Decision Making ◽  
Pediatric Population ◽  
Clinical Decision ◽  
Auditory Processing Disorder ◽  
Evidence Based ◽  
Vocal Cues ◽  
Research Paradigms

Abstract Audiologists are seeking evidence to guide clinical decision-making regarding the tests used to diagnose auditory processing disorder (APD) in children. Novel research paradigms using a population health framework hold promise in helping clinicians understand the prevalence, profile, and social underpinnings of APD in the general pediatric population. In addition, tests employing novel stimuli like speech-evoked auditory potentials or spatial and vocal cues may lead the way toward a new and more reliable APD test battery.

Narrative Review of Evidence Based Intervention Approaches for Auditory Processing Disorder (APD)

2017 ◽  
Vol 2 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Moumita Choudhury ◽  
Patricia Chavira
Keyword(s):  
Current Literature ◽  
Auditory Processing ◽  
Narrative Review ◽  
Auditory Processing Disorder ◽  
Evidence Based ◽  
Short Term ◽  
Treatment Approaches

This review studies the current literature available on intervention approaches of auditory processing disorder (APDAPD intervention approaches should be based on specific deficits and customized to accommodate the needs of each patient. The discussion on the efficacy of various APD treatment approaches suggested that there is lack of evidence that short-term intervention improves auditory functioning. Increased understanding of the pathophysiologic bases of APD and systematic long-term research on APD interventions would fill the gaps in our knowledge and provide more definitive intervention recommendations.

Auditory Processing Disorder and Its Comorbidities: A Need for Consistency in Test Cutoff Scores

2021 ◽  
Vol 30 (1) ◽  
pp. 128-144
Author(s):  
Ansar U. Ahmmed
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Language Impairment ◽  
Auditory Processing ◽  
Rating Scale ◽  
Manual Dexterity ◽  
Auditory Processing Disorder ◽  
Hyperactivity Disorder ◽  
Parental Rating ◽  
Movement Assessment

Purpose No gold standard criteria exist for diagnosing developmental auditory processing disorder (APD). This study aimed to identify APD criteria, which are consistent with that used for comorbidities, and how comorbidities predicted APD. Method A retrospective study of 167 participants (males = 105, females = 62; age: 6–16 years; nonverbal IQ > 80) with suspected APD is presented. Five SCAN-3 tests evaluated auditory processing (AP). Comorbidities included attention-deficit/hyperactivity disorder, language impairment, and impaired manual dexterity, which were identified using percentile ≤ 5 in the Swanson, Nolan and Pelham parental rating scale; Children's Communication Checklist-2; and Movement Assessment Battery for Children-2, respectively. Results Percentiles ≤ 9, ≤ 5, and < 2 in two or more AP tests had sensitivities (specificities) of 76% (70.6%), 59.3% (76.5%), and 26% (82.4%), respectively, in predicting comorbidities, which were present in 150 of the 167 participants. The criterion of “≤ 9 percentile in two or more AP tests” (Approach I) diagnosed APD in 119 participants, and criterion “≤ 5 percentile in two or more AP tests or ≤ 5 percentile in one AP plus one or more measures of comorbidities” (Approach II) diagnosed 123. The combination of approaches diagnosed 128 participants (76.6%) with APD, of which 114 were diagnosed by each approach (89%). Language impairment and impaired manual dexterity, but not attention-deficit/hyperactivity disorder, predicted APD. Conclusions “Percentile ≤ 9 in two or more AP tests” or “percentile ≤ 5 in one AP plus one or more measures of comorbidities” are evidence-based APD diagnostic criteria. Holistic and interprofessional practice evaluating comorbidities including motor skills is important for APD.

On Diagnostic Accuracy in Audiology: Central Site of Lesion and Central Auditory Processing Disorder Studies

2016 ◽  
Vol 27 (02) ◽  
pp. 141-156 ◽  
Author(s):  
Andrew J. Vermiglio
Keyword(s):  
Diagnostic Accuracy ◽  
Auditory Processing ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Index Test ◽  
Test Results ◽  
Reference Standard ◽  
Central Auditory Processing Disorder ◽  
Target Condition ◽  
Independent Verification

Background: In the field of audiology a test protocol (index test) is used to determine the presence or absence of a target condition. The value of an index test rests in its diagnostic accuracy. Results from an index test must be verified through the use of a reference standard. The clinician and researcher should determine the quality and applicability of diagnostic accuracy studies. The Standards for Reporting of Diagnostic Accuracy (STARD) statement was published in response to the low quality of research conducted across many fields of study. It provides guidelines for the development and interpretation of diagnostic accuracy studies. Purpose: The primary purpose of this article is to assess the degree to which the main principles of diagnostic accuracy studies are used for the detection of central auditory nervous system lesions and a central auditory processing disorder (CAPD). The secondary purpose is to compare the design of these studies to select key guidelines from the STARD statement. The third purpose of this article is to present an argument against the reassignment of diagnostic accuracy values of a particular index test for one target condition (e.g., a central site of lesion) to a different target condition (e.g., a CAPD). Results: A review of diagnostic accuracy literature on the detection of a central site of lesion reveals the use of a reference standard for the independent verification of the index test results. However, diagnostic accuracy studies involving index tests for the detection of a CAPD show that independent verification of index test results is nonexistent or at best questionable. Conclusion: For a particular index test, while the diagnostic accuracy for detection of a central site of lesion may have been determined appropriately, it is inappropriate to reassign these diagnostic accuracy values to a different diagnostic target such as a CAPD.

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