Audiologists are selecting AP test batteries based on the age and case history of the patient, which is in accordance with recent national guidelines. Audiologists are primarily responsible for APD diagnosis and recommending treatment/management. APD treatment is provided by speech-language pathologists, educators, and audiologists.

The data collected in this study are appropriate for use in clinical diagnosis of APD. Use of a low-linguistically loaded core battery with the addition of more language-based tests, when language abilities are known, can provide a well-rounded picture of a child's auditory processing abilities. Screening for language, phonological processing, attention, and cognitive level can provide more information regarding a diagnosis of APD, determine appropriateness of the test battery for the individual child, and may assist with making recommendations or referrals. It is important to use a multidisciplinary approach in the diagnosis and treatment of APD due to the high likelihood of comorbidity with other language, learning, or attention deficits. Although children with other diagnoses may be tested for APD, it is important to establish previously made diagnoses before testing to aid in appropriate test selection and recommendations.

The results suggest that future revisions of relevant international and national standards should address the use of an adjustable headstrap and a static force less than 5.4 N.

A survey of auditory processing (AP) diagnostic practices was mailed to all licensed audiologists in the State of Maryland and sent as an electronic mail attachment to the American Speech-Language-Hearing Association and Educational Audiology Association Internet forums. Common AP protocols (25 from the Internet, 28 from audiologists in Maryland) included requiring basic audiologic testing, using questionnaires, and administering dichotic listening, monaural low-redundancy speech, temporal processing, and electrophysiologic tests. Some audiologists also administer binaural interaction, attention, memory, and speech-language/psychological/educational tests and incorporate a classroom observation. The various AP batteries presently administered appear to be based on the availability of AP tests with well-documented normative data. Resources for obtaining AP tests are listed.

Tympanometry and ART tests have remained popular for the past 30 years, whereas acoustic reflex decay (ARD) testing has decreased in popularity. MF and MC tympanometry are conducted infrequently. AR is frequently associated with discomfort but rarely associated with other symptoms. However, one respondent reported that AR testing had caused permanent tinnitus and hearing loss.

Detection of the target signal deteriorated as background noise level increased and was dependent on the source location of the incoming signal, as expected. Localization accuracy of the target signal was highly dependent on the SNR and spatial location of the signal source. Detection and localization accuracy data were found to be repeatable across test sessions and response patterns were found to be symmetrical on the right and left sides of the horizontal plane.

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SNR had great impact on the ability of listeners to understand speech in the presence of background noise; however, the type of noise and the type of level-dependent device used did not. The results of the study support the notion that individuals potentially subjected to high-level impulse noise should be able to use level-dependent earplugs in low-level continuous noise without compromising speech understanding. More specifically, the passive, level-dependent earplugs currently used by military personnel do not appear to be detrimental to speech communication for listeners with normal hearing when the speech is at an average conversational level and the listener is actively attending to the signal.