(Central) Auditory Processing Disorder Grand Rounds: Multiple Cases, Multiple Causes, Multiple Outcomes

Richburg, Cynthia McCormick; Atcherson, Samuel R.; Findlen, Ursula M; Wakefield, Sarah; Benafield, Natalie J.

doi:10.1044/2017_aja-16-0074

Cited by 3 publications

(3 citation statements)

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“…Children with suspected APDs have been reported to differ from control group children without auditory difficulties on measures of attention, memory, reading and/or language skills. Comorbidity of APDs with other neurodevelopmental conditions is a norm rather than an exception (Sharma et al, 2009; Musiek et al, 2010; Tomlin et al, 2015); the proportion of children with co-occurring conditions varies across studies but is typically about 40–50% (Sharma et al, 2009; Ferguson et al, 2011). Variations are likely to reflect sampling and test protocol differences across studies.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians working with children with suspected APD face three important challenges. One is that auditory processing is not a unitary skill and therefore cannot be assessed with one test (Jerger and Musiek, 2000; Wilson, 2018), hence clinicians need to access a range of tests that have age-dependent norms and demonstrated reliability, test efficiency and validity (Musiek et al, 2010; Emanuel et al, 2011; Wilson, 2018; Keith et al, 2019). For example, commonly used tests such as the FPT (Musiek, 1994) and the DDT (Musiek, 1983) have age-related norms while the Random Gap Detection Test (RGDT) has a screening pass level that is applied to all school aged children (Sharma et al, 2006; Kelly, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Cluster Analyses Reveals Subgroups of Children With Suspected Auditory Processing Disorders

2019

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BackgroundSome children appear to not hear well in class despite normal hearing sensitivity. These children may be referred for auditory processing disorder (APD) assessment but can also have attention, language, and/or reading disorders. Despite presenting with similar concerns regarding hearing difficulties in difficult listening conditions, the overall profile of deficits can vary in children with suspected or confirmed APD. The current study used cluster analysis to determine whether subprofiles of difficulties could be identified within a cohort of children presenting for auditory processing assessment.MethodsNinety school-aged children (7–13 years old) with suspected APDs were included in a cluster analysis. All children had their reading, language, cognition and auditory processing assessed. Parents also completed the Children’s Auditory Performance Scale (CHAPS). Cluster analysis was based on tasks where age-norms were available, including word reading (Castles and Coltheart irregular and non-words test), phonological awareness (Queensland University Inventory of Literacy), language [Comprehensive Language of Assessment-4, Comprehensive Assessment of Spoken Language (CASL)], sustained attention (Continuous Performance Test), working memory (digits forward and backward), and auditory processing [Frequency Pattern Test (FPT), Dichotic Digits Test (DDT)]. Hierarchical cluster analysis was undertaken to determine the optimal number of clusters for the data, followed by a k-means cluster analysis.ResultsHierarchical cluster analysis suggested a four-group solution. The four subgroups can be summarized as follows: children with (1) global deficits, n = 35; (2) poor auditory processing with good word reading and phonological awareness skills, n = 22; (3) poor auditory processing with poor attention and memory but good language skills, n = 15; and (4) poor auditory processing and attention with good memory skills, n = 18.ConclusionThe cluster analysis identified distinct subgroups of children. These subgroups display the variation in areas of difficulty observed across different studies in the literature (e.g., not every child with APD has an attention deficit), highlighting the heterogeneous nature of APD and the need to assess a range of skills in children with suspected APD. It would be valuable for future studies to independently verify these subgroups and to determine whether interventions can be optimized based on these subgroups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cluster Analyses Reveals Subgroups of Children With Suspected Auditory Processing Disorders

2019

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“…Regardless of the reasoning behind the development of a test protocol and materials, the ultimate test of a SRN protocol should be its ability to detect the presence and absence of a target disorder. The disorder could be an SRN disorder (Middelweerd et al, 1990;Vermiglio, Soli, et al, 2017), elevated pure-tone thresholds (Wilson, McArdle, et al, 2007), a lesion of the central auditory nervous system (Sinha, 1959;Richburg et al, 2017), or perhaps auditory neuropathy (Berlin, 2012). Clinicians and researchers should know the diagnostic accuracy of the available SRN protocols.…”

Section: Implications For Clinical Work and Researchmentioning

confidence: 99%

Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

et al. 2019

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Speech recognition in noise (SRN) evaluations reveal information about listening ability that is unavailable from pure-tone thresholds. Unfortunately, SRN evaluations are not commonly used in the clinic. A lack of standardization may be an explanation for the lack of widespread acceptance of SRN testing. Arguments have been made for the utilization of steady-state speech-shaped noise vs. multi-talker babble. Previous investigations into the effect of masker type have used a monaural presentation of the stimuli. However, results of monaural SRN tests cannot be generalized to binaural listening conditions.The purpose of this study was to investigate the effect of masker type on SRN thresholds under binaural listening conditions.The Hearing in Noise Test (HINT) protocol was selected in order to measure SRN thresholds in steady-state speech-shaped noise (HINT noise) and four-talker babble with and without the spatial separation of the target speech and masker stimuli.Fifty native speakers of English with normal pure-tone thresholds (≤ 25 dB HL, 250–4000 Hz) participated in the study. The mean age was 20.5 years (SD 1.01).All participants were tested using the standard protocol for the HINT in a simulated soundfield environment under TDH-50P headphones. Thresholds were measured for the Noise Front, Noise Left, and Noise Right listening conditions with HINT noise and four-talker babble. The HINT composite score was determined for each noise condition. The spatial advantage was calculated from the HINT thresholds. Pure-tone threshold data were collected using the modified Hughson-Westlake procedure. Statistical analyses include descriptive statistics, effect size, correlations, and repeated measures ANOVA followed by matched-pairs t-tests.Repeated measures ANOVA was conducted to investigate the effects of masker type and noise location on HINT thresholds. Both main effects and their interaction were statistically significant (p < 0.01). No significant differences were found between masker conditions for the Noise Front thresholds. However, for the Noise Side conditions the four-talker babble thresholds were significantly better than the HINT noise thresholds. Overall, greater spatial advantage was found for the four-talker babble as opposed to the HINT noise conditions (p < 0.01). Pearson correlation analysis revealed no significant relationships between four-talker babble and HINT noise speech recognition performances for the Noise Front, Noise Right conditions, and the spatial advantage measures. Significant relationships (p < 0.05) were found between masking noise performances for the Noise Left condition and the Noise Composite scores.One cannot assume that a patient who performs within normal limits on a speech in four-talker babble test will also perform within normal limits on a speech in steady-state speech-shaped noise test, and vice-versa. Additionally, performances for the Noise Front condition cannot be used to predict performances for the Noise Side conditions. The utilization of both HINT noise and four-talker babble maskers, with and without the spatial separation of the stimuli, may be useful when determining the range of speech recognition in noise abilities found in everyday listening conditions.

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Factores de riesgo asociados al trastorno de procesamiento auditivo central

Leines¹,

García²,

Márquez³

et al. 2022

Investigación en Discapacidad

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(Central) Auditory Processing Disorder Grand Rounds: Multiple Cases, Multiple Causes, Multiple Outcomes

Cited by 3 publications

References 24 publications

Cluster Analyses Reveals Subgroups of Children With Suspected Auditory Processing Disorders

Cluster Analyses Reveals Subgroups of Children With Suspected Auditory Processing Disorders

Sentence Recognition in Steady-State Speech-Shaped Noise versus Four-Talker Babble

Factores de riesgo asociados al trastorno de procesamiento auditivo central

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