An Opinion on the Assessment of People Who May Have an Auditory Processing Disorder

2012 ◽  
Vol 23 (02) ◽  
pp. 097-105 ◽  
Author(s):  
Harvey Dillon ◽  
Sharon Cameron ◽  
Helen Glyde ◽  
Wayne Wilson ◽  
Dani Tomlin
Keyword(s):  
At Risk ◽  
Auditory Processing ◽  
Specific Form ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
Test Results ◽  
Hierarchical Approach ◽  
Clinical Efficiency ◽  
Impaired Ability ◽  
The Individual

We need to rethink how we assess auditory processing disorder (APD). The current use of test batteries, while necessary and well accepted, is at risk of failing as the size of these batteries increases. To counter the statistical, fatigue, and clinical efficiency problems of large test batteries, we propose a hierarchical approach to APD assessment. This begins with an overall test of listening difficulty in which performance is measurably affected for anyone with an impaired ability to understand speech in difficult listening conditions. It proceeds with a master test battery containing a small number of single tests, each of which assesses a different group of skills necessary for understanding speech in difficult listening conditions. It ends with a detailed test battery, where the individual tests administered from this battery are only those that differentiate the skills assessed by the failed test(s) from the master test battery, so that the specific form of APD can be diagnosed. An example of how hierarchical interpretation of test results could be performed is illustrated using the Listening in Spatialized Noise—Sentences test (LiSN-S). Although consideration of what abilities fall within the realm of auditory processing should remain an important issue for research, we argue that patients will be best served by focusing on whether they have difficulty understanding speech, identifying the specific characteristics of this difficulty, and specifically remediating and/or managing those characteristics.

The Listening in Spatialized Noise Test: An Auditory Processing Disorder Study

2006 ◽  
Vol 17 (05) ◽  
pp. 306-320 ◽  
Author(s):  
Sharon Cameron ◽  
Harvey Dillon ◽  
Philip Newall
Keyword(s):  
At Risk ◽  
Auditory Processing ◽  
Three Dimensional ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
Children At Risk ◽  
Normal Range ◽  
Vocal Cues ◽  
Noise Test ◽  
Db Difference

The Listening in Spatialized Noise test (LISN)® produces a virtual three-dimensional auditory environment under headphones. Various measures assess the extent to which either spatial, vocal, or spatial and vocal cues combined increase a listener's ability to comprehend a target story in the presence of distracter sentences, without being affected by differences between participants in variables such as linguistic skills. Ten children at risk for auditory processing disorder (APD group) were assessed on the LISN, as well as a traditional APD test battery. The APD group performed significantly more poorly on all LISN measures than 48 age-matched controls. On the spatial advantage measure, the APD group achieved a mean advantage of only 3.7 dB when the distracters were spatially separated from the target by ±90°, compared to 10.0 dB for the controls—the 6.3 dB difference significant at p < 0.000001, with nine children scoring outside the normal range. The LISN was considered a promising addition to an APD test battery.

An Objective Approach Toward Understanding Auditory Processing Disorder

2021 ◽  
pp. 1-6
Author(s):  
Akshay R. Maggu ◽  
Tobias Overath
Keyword(s):  
Clinical Practice ◽  
Auditory Processing ◽  
Test Battery ◽  
Domain Specificity ◽  
Auditory Processing Disorder ◽  
Theoretical Construct ◽  
Ongoing Debate ◽  
Current Definition ◽  
Definition Of ◽  
Shed Light

Purpose In the field of audiology, auditory processing disorder (APD) continues to be a topic of ongoing debate for clinicians and scientists alike, both in terms of theory and clinical practice. In the current viewpoint, we first lay out the main issues that are central to the controversy surrounding APD, and then suggest a framework toward their resolution. Method The current viewpoint is informed by reviewing existing studies in the field of APD to better understand the issues contributing to the controversies in APD. Results We found that, within the current definition of APD, the two main issues that make the APD diagnosis controversial are (a) comorbidity with other disorders and (b) the lack of domain specificity. These issues remain unresolved, especially with the use of the existing behavioral APD test batteries. In this viewpoint, we shed light on how they can be mitigated by implementing the administration of an objective, physiological test battery. Conclusions By administering an objective test battery, as proposed in this viewpoint, we believe that it will be possible to achieve a higher degree of specificity to the auditory domain that will not only contribute towards clinical practice but also contribute towards strengthening APD as a theoretical construct.

Observations on the Use of SCAN to Identify Children at Risk for Central Auditory Processing Disorder

1997 ◽  
Vol 28 (1) ◽  
pp. 43-49 ◽  
Author(s):  
Maria F. Emerson ◽  
Kami K. Crandall ◽  
J. Anthony Seikel ◽  
Gail D. Chermak
Keyword(s):  
At Risk ◽  
Auditory Processing ◽  
School Setting ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Auditory Processing Disorders ◽  
Children At Risk ◽  
Central Auditory Processing Disorder ◽  
History Of ◽  
Audiometric Test

The SCAN: A Screening Test for Auditory Processing Disorders was designed for administration in a quiet school test setting, although it is also administered by audiologists in the audiometric booth in a study seeking to screen for the presence of central auditory processing disorder (CAPD) in children with a history of otitis media (OM), 14 children with a history of OM and an equal number without this risk factor for CAPD (non-OM) were tested in a school setting using the SCAN and the Peabody Picture Vocabulary Test-Revised (PPVT-R). Forty-three percent of the OM group failed the SCAN, as did 29% of the non-OM group; hence, the groups were not differentiated using the SCAN. To prove the effects of environment on test results, a second experiment was conducted in which six additional children were administered the SCAN in both a school setting and an audiometric test booth. Individual data revealed that subjects performed more poorly on the SCAN administered in the school setting than in audiometric test booth. The marked difference in SCAN scores between the two environments raises methodological concerns regarding the use of this instrument for indentification of children at risk for central auditory processing disorders.

Implementation and evaluation of a Danish test battery for auditory processing disorder in children

2017 ◽  
Vol 56 (8) ◽  
pp. 538-549 ◽  
Author(s):  
Ellen Raben Pedersen ◽  
Berit Dahl-Hansen ◽  
Jakob Christensen-Dalsgaard ◽  
Christian Brandt
Keyword(s):  
Auditory Processing ◽  
Test Battery ◽  
Auditory Processing Disorder

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

2021 ◽  
pp. 1-10
Author(s):  
Ronald L. Schow ◽  
Harvey Dillon ◽  
Jessica Hillam ◽  
Mary M. Whitaker ◽  
J. Anthony Seikel
Keyword(s):  
Auditory Processing ◽  
Normal Development ◽  
Behavioral Assessment ◽  
The United States ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
Future Research ◽  
Binaural Interaction ◽  
Processing Abilities ◽  
Comprehensive Test

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.

scholarly journals Prevalence of Auditory Processing Disorder in School-Aged Children in the Mid-Atlantic Region

2016 ◽  
Vol 27 (09) ◽  
pp. 691-700 ◽  
Author(s):  
Kyoko Nagao ◽  
Tammy Riegner ◽  
Jennifer Padilla ◽  
L. Ashleigh Greenwood ◽  
Jessica Loson ◽  
...  
Keyword(s):  
African American ◽  
Public Schools ◽  
Private Schools ◽  
Auditory Processing ◽  
School Enrollment ◽  
Demographic Characteristics ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
African American Children ◽  
American Children

Background: Although auditory processing disorder (APD) is a widely recognized impairment, its prevalence and demographic characteristics are not precisely known in the pediatric population. Purpose: To examine the demographic characteristics of children diagnosed with APD at a tertiary health-care facility and the prevalence of pediatric APD. Research Design: A cross-sectional study. Study Sample: A total of 243 children (149 boys and 94 girls) who were referred to the Nemours Audiology Clinics in the Delaware Valley for an APD evaluation. The mean ages were 9.8 yr for boys and 9.7 yr for girls. Out of 243 children referred for an APD evaluation, 94 children exhibited one or more auditory processing deficits in the areas of auditory closure, auditory figure ground, binaural integration, binaural separation, and temporal processing. Data Collection and Analysis: Demographic and audiological data, clinical history (parental reports on prenatal and postnatal information, birth weight and height, medical and developmental history, otologic/audiological history, education information, behavioral characteristics), and results of the APD test battery were retrospectively obtained from the electronic medical records of each participant. The prevalence of APD was estimated using the total number of students enrolled in the same school attended by each participant in the 2011 academic year as cohort. Results: The prevalence of APD was 1.94 per 1,000 children in this study. We found that prevalence of APD among the children who attended private schools was more than two times higher than the children who attended public schools. The results also revealed that the majority of children referred to the clinics were Caucasian (85.6%), whereas minority groups were underrepresented for this geographical area with only 3.7% of Hispanic or Latino children and 5.8% of Black or African American children. Conclusions: The estimated prevalence of APD in the current study was lower than the previously published estimates. The difference might be due to the diagnosis criteria of APD among studies as well as the use of school enrollment number as the referenced population to estimate prevalence in our study. We also found a significant difference in APD prevalence depending on the school types. The findings of higher prevalence rates among the children attending private schools and higher proportion of Caucasians children referred for APD evaluation suggest that more children among those in public schools and in the Hispanic and African American groups should have been referred for an APD evaluation. Hence, the current estimate is likely an underestimate of the actual APD prevalence. The low percentage of Hispanic or African American children referred to the clinic for APD evaluations may be related to the socioeconomic status and linguistic differences among the concerned families. The results of this study raise the importance of adapting the APD test battery for children with a different linguistic background as well as increasing awareness of available clinical resources to all families in our area.

The Listening in Spatialized Noise–Sentences Test (LISN-S): Comparison to The Prototype Lisn and Results From Children With Either a Suspected (Central) Auditory Processing Disorder or a Confirmed Language Disorder

2008 ◽  
Vol 19 (05) ◽  
pp. 377-391 ◽  
Author(s):  
Sharon Cameron ◽  
Harvey Dillon
Keyword(s):  
Performance Measures ◽  
Auditory Processing ◽  
Test Battery ◽  
Stream Segregation ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Auditory Stream ◽  
Auditory Stream Segregation ◽  
Competing Speech

Background: The Listening in Spatialized Noise—Sentences test (LISN-S®) is a revised version of the Listening in Spatialized Noise (Continuous Discourse) test (LISN®; Cameron et al, 2006a). The software produces a three-dimensional auditory environment under headphones and was developed to assess auditory stream segregation skills in children. A simple repetition response protocol is utilized to determine speech reception thresholds (SRTs) for sentences presented from 0° azimuth in competing speech. The competing speech is manipulated with respect to its location in auditory space (0° vs. + and −90° azimuth) and the vocal quality of the speaker(s) (same as, or different to, the speaker of the target stimulus). Performance is measured as two SRT and three advantage measures. The advantage measures represent the benefit in dB gained when either talker, spatial, or both talker and spatial cues combined are incorporated in the maskers. Purpose: To document LISN-S performance in a group of nine children with suspected (central) auditory processing disorder ([C]APD), who presented with difficulties hearing in the classroom in the absence of any routine audiological or language, learning or attention deficits to explain such a difficulty (SusCAPD group). The study also aimed to research the effect of higher-order deficits on LISN-S performance in a group of 11 children with a range of documented learning or attention disorders (LD Group). Correlation between performance on the LISN-S and a traditional (C)APD test battery was also compared. Research Design: In a descriptive design, SusCAPD and LD group performance on the LISN-S was compared to published normative data from 70 age-matched controls. A correlational design was used to compare performance on the various tests in the traditional (C)APD battery to the SRT and advantage measures of the LISN-S. Results: There were no significant differences between the SusCAPD, LD, or control groups on the conditions of the LISN-S where both the target and maskers emanated from 0° azimuth (low-cue SRT, p = 0.978; talker advantage, p = 0.307). However, there were significant differences between groups on the performance measures where the maskers were separated from the target by + and −90°. Post hoc tests revealed that there were no significant differences between the LD group and controls on any of these measures. There were, however, significant differences between the SusCAPD group and the controls on all the conditions where the maskers were spatially separated from the target (high-cue SRT, p = 0.001; spatial advantage, p < 0.0001; total advantage, p < 0.0001). The LISN-S did not correlate significantly with any test in the traditional test battery, nor were the nonspatial and spatial performance measures of the LISN-S correlated. Conclusions: The study supports the hypothesis that a high proportion of children with suspected (C)APD have a deficit in the mechanisms that normally use the spatial distribution of sources to suppress unwanted signals. The LISN-S is a potentially valuable assessment tool for assessing auditory stream segregation deficits, and is sensitive in differentiating various forms of auditory streaming.

scholarly journals Impact of different cutoff criteria on rate of (central) auditory processing disorders diagnosis using the central test battery

2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Mohsin Ahmed Shaikh ◽  
Lisa Fox-Thomas ◽  
Denise Tucker
Keyword(s):  
Auditory Processing ◽  
The United States ◽  
Test Battery ◽  
Auditory Processing Disorder ◽  
Central Auditory Processing ◽  
Central Auditory Processing Disorder ◽  
Central Auditory Processing Disorders ◽  
The Mean ◽  
Test Failure ◽  
Cutoff Criteria

The purpose of this study was to quantify how the use of two different cutoff criteria affects the test failure rate and potential diagnosis of central auditory processing disorder ([C]APD) in a sample of children subjected to central auditory processing ([C]AP) assessment. Test failure rates for the central test battery (CTB) using two different cutoff criteria (1 and 2 SDs below the mean) were measured retrospectively for 98 children who completed (C)AP assessment. The rates of potential (C)APD diagnosis ranged from 86.8% [when a 1 standard deviation (SD) cutoff was used] to 66.2% (when a 2 SD cutoff was used). The current use of two different cutoffs for the CTB has a large impact on the diagnostic rate for (C)APD. These findings have clinical implications for the diagnosis of (C)APD due to the widespread use of the CTB in the United States for the assessment of (C)APD in children. Thus, it is important to create awareness among audiologists that use of the 2 SDs cutoff criterion is recommended for reducing false positives (error).

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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