Three Commonly Asked Questions About Central Auditory Processing Disorders: Assessment

Auditory Processing Disorder Test Battery in European Portuguese-Development and Normative Data for Pediatric Population

There is an increasing need for state-of-the-art Central Auditory Processing assessment for Portuguese native speakers, applicable as early as possible. As a contribution to answering this need, this paper presents a new battery for Central Auditory Processing assessment for European Portuguese applicable to children aged 5 and above, named BAPA-PE, providing information regarding test selection and development. The battery consists of six behavioral tests: Staggered Spondaic Words (SSW) for European Portuguese, Filtered Speech, Speech in Noise, Detection Interval in Noise, Duration, and Frequency Pattern. The normative data for children aged 5 to 12 are also reported. A sample was obtained of 217 subjects without ear pathology and with typical development. Each age group was composed of at least 30 children. All children were evaluated using pure tone audiometry, speech audiometry, impedance, and otoacoustic emissions. Normative scores are reported for each of the six auditory processing tests. The assessment is applicable to young children (aged 5 and 6). The statistical analyses showed significant effects in scores of Age for all tests and of Ear for several tests. The main result from the work presented, the Auditory Processing Assessment Battery—European Portuguese (BAPA-PE), is available for clinical use with normative data. This battery is a new tool for behaviorism assessment of European Portuguese speakers with suspected central auditory pathology and for monitoring the results of auditory training.

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

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.

The Peripheral Hearing and Central Auditory Processing Skills of Individuals With Subjective Memory Complaints

Purpose

This study examined the central auditory processing (CAP) assessment results of adults between 45 and 85 years of age with probable pre-clinical Alzheimer’s disease – i.e., individuals with subjective memory complaints (SMCs) as compared to those who were not reporting significant levels of memory complaints (non-SMCs). It was hypothesized that the SMC group would perform significantly poorer on tests of central auditory skills compared to participants with non-SMCs (control group).

Methods

A total of 95 participants were recruited from the larger Western Australia Memory Study and were classified as SMCs (N = 61; 20 males and 41 females, mean age 71.47 ±7.18 years) and non-SMCs (N = 34; 10 males, 24 females, mean age 68.85 ±7.69 years). All participants completed a peripheral hearing assessment, a CAP assessment battery including Dichotic Digits, Duration Pattern Test, Dichotic Sentence Identification, Synthetic Sentence Identification with Ipsilateral Competing Message (SSI-ICM) and the Quick-Speech-in-Noise, and a cognitive screening assessment.

Results

The SMCs group performed significantly poorer than the control group on SSI-ICM −10 and −20 dB signal-to-noise conditions. No significant differences were found between the two groups on the peripheral hearing threshold measurements and other CAP assessments.

Conclusions

The results suggest that individuals with SMCs perform poorly on specific CAP assessments in comparison to the controls. The poor CAP in SMC individuals may result in a higher cost to their finite pool of cognitive resources. The CAP results provide yet another biomarker that supports the hypothesis that SMCs may be a primary indication of neuropathological changes in the brain. Longitudinal follow up of individuals with SMCs, and decreased CAP abilities should inform whether this group is at higher risk of developing dementia as compared to non-SMCs and those SMC individuals without CAP difficulties.

Validity of the Multiple Auditory Processing Assessment-2: A Test of Auditory Processing Disorder

Purpose A normative study using the Multiple Auditory Processing Assessment-2 (MAPA-2; Schow et al., 2018) was recently completed. With access to these data, the authors extend that work and support a definite construct for auditory processing disorder (APD). The goal here is to examine MAPA-2 reliability and validity (construct, content, and concurrent). Evidence for the APD construct is further buttressed by measures of sensitivity and specificity. Results of MAPA-2 testing on children diagnosed with learning disability (LD), attention-deficit/hyperactivity disorder (ADHD), and specific language impairment (SLI) are included. Method Normative data (previously published as the MAPA-2) allowing derivation of these findings included a representative sample of 748 children (53% girls) ages 7-14 years tested by 54 speech-language pathologists and audiologists in 27 U.S. states. The authors examined diagnostic accuracy based on the American Speech-Language-Hearing Association (2005) criteria (index test) for confirmed cases of APD. The index was also used to identify listening problems for three other diagnostic categories (LD, ADHD, and SLI). Validated questionnaire responses from parents and school personnel allowed incorporation of functional measures widely supported in APD diagnosis but unavailable with other normative and sensitivity/specificity studies. Results Reliability and validity were both satisfactory, and diagnostic accuracy for an APD group of 18 (28% female) compared to the remaining typical group of 625 yielded 89% sensitivity and 82% specificity. The remaining three groups (LD, ADHD, and SLI), where comorbidity was expected to be about 50%, had APD-type listening problems with a prevalence ranging from 52% to 65%. Conclusions Current results provide important evidence for the construct of APD. The MAPA-2 can be administered by an audiologist or speech-language pathologist. A similar diagnostic protocol in Australia yielded positive therapeutic gains. Further study is encouraged to determine if the present positive findings will be found in future research.

Working Memory and Auditory Processing in School-Age Children

Purpose

Our goal is to present the relationships between working memory (WM) and auditory processing abilities in school-age children.

Review and Discussion

We begin with an overview of auditory processing, the conceptualization of auditory processing disorder, and the assessment of auditory processing abilities in children. Next, we describe a model of WM and a model of auditory processing followed by their comparison. Evidence for the relationships between WM and auditory processing abilities in school-age children follows. Specifically, we present evidence for the association (or lack thereof) between WM/attention and auditory processing test performance.

Clinical Implications

In conclusion, we describe a new framework for understanding auditory processing abilities in children based on integrated evidence from cognitive science, hearing science, and language science. We also discuss clinical implications in children that could inform future research.

Abnormal Resting-State Quantitative Electroencephalogram in Children With Central Auditory Processing Disorder: A Pilot Study

In this study, we showed an abnormal resting-state quantitative electroencephalogram (QEEG) pattern in children with central auditory processing disorder (CAPD). Twenty-seven children (16 male, 11 female; mean age = 10.7 years) with CAPD and no symptoms of other developmental disorders, as well as 23 age- and sex-matched, typically developing children (TDC, 11 male, 13 female; mean age = 11.8 years) underwent examination of central auditory processes (CAPs) and QEEG evaluation consisting of two randomly presented blocks of “Eyes Open” (EO) or “Eyes Closed” (EC) recordings. Significant correlations between individual frequency band powers and CAP tests performance were found. The QEEG studies revealed that in CAPD relative to TDC there was no effect of decreased delta absolute power (1.5–4 Hz) in EO compared to the EC condition. Furthermore, children with CAPD showed increased theta power (4–8 Hz) in the frontal area, a tendency toward elevated theta power in EO block, and reduced low-frequency beta power (12–15 Hz) in the bilateral occipital and the left temporo-occipital regions for both EO and EC conditions. Decreased middle-frequency beta power (15–18 Hz) in children with CAPD was observed only in the EC block. The findings of the present study suggest that QEEG could be an adequate tool to discriminate children with CAPD from normally developing children. Correlation analysis shows relationship between the individual EEG resting frequency bands and the CAPs. Increased power of slow waves and decreased power of fast rhythms could indicate abnormal functioning (hypoarousal of the cortex and/or an immaturity) of brain areas not specialized in auditory information processing.

Processamento auditivo temporal em crianças com transtorno do déficit de atenção com hiperatividade (TDAH)

OBJETIVO:comparar os achados da avaliação comportamental do processamento auditivo temporal em crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade.MÉTODOS:participaram desse estudo 30 crianças na faixa etária de 8 a 12 anos, sendo 15 do grupo controle e 15 do grupo pesquisa, com limiares audiométricos dentro dos padrões de normalidade. Como procedimentos foram realizados os testes temporais de padrão de frequência e de duração.RESULTADOS:na comparação entre o grupo controle e grupo pesquisa em ambos os testes - padrão de frequência e padrão de duração foram verificadas diferenças significantes entre os grupos, sendo que o grupo pesquisa apresentou resultados alterados em sua maioria, enquanto que todas as crianças do grupo controle apresentaram resultados normais. Foi possível observar ainda que todas as crianças de ambos os grupos tiveram resultados inferiores para o Padrão de Duração quando comparado aos resultados do Padrão de Frequência e.CONCLUSÃO:a avaliação comportamental do processamento auditivo temporal de crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade, mostrou que os sujeitos com Transtorno do Déficit de Atenção com Hiperatividade apresentaram alterações, enquanto que o grupo sem Transtorno do Déficit de Atenção com Hiperatividade resultados normais em ambos os testes. O presente estudo possibilitou um maior conhecimento da via auditiva central das crianças com e sem Transtorno do Déficit de Atenção com Hiperatividade, porém, outros estudos ainda se fazem necessários, principalmente na literatura nacional, a fim de se conhecer melhor o funcionamento do processamento auditivo dessas populações.

Association between top-down skills and auditory processing tests

Today, we are questioning how top-down skills may interfere with performance on auditory processing tests.

Objective

To investigate the existence of a possible association between memory, attention and language skills in auditory processing tests in “normal” development children.

Method

Twenty children (ages 7 to 9 years), without complaints related to verbal and/or written language skills; without overt neurological or psychological involvement or delayed psychomotor development. We employed Hearing and auditory Processing Assessment tests in addition to psychophysical tests (visual and auditory attention tests; memory tests for digits and syllables and phonological awareness tests).

Results

there was a “very strong” correlation between Frequency Pattern and Memory for Digits Tests; a “strong” correlations between SSW (LE) test and Memory for Syllables, and SSW (LE) test and phonemic tasks.

Conclusion

the Frequency Pattern Test showed a strong correlation with the phonological working memory skill; just as the SSW had with language and memory skills for syllables. It is noteworthy the difficult to clinically interpret the results of each auditory processing test alone, since these may be dependent on skills not necessarily related to the auditory modality, such as memory and language.

Hearing abilities in children with dyslexia and attention deficit hyperactivity disorder

BACKGROUND

auditory processing and co-occurrence of pathologies.

AIM

to investigate the performance of children with Dyslexia and attention deficit hyperactivity disorder (ADHD) in behavioral and auditory processing tests, comparing the results to a control group.

METHOD

participants of the study were 30 children, with ages between 7 and 12 years, divided into three groups: a control group of 10 children, a study group of 10 children with dyslexia and a study group of 10 children with ADHD. All participants were submitted to the following auditory processing tests: Speech in Noise, Dichotic of Digits and Frequency Pattern.

RESULTS

concerning the Speech in Noise Test, there was an interactive effect between the control group and the ADHD group (p < 0.001), with the ADHD group presenting a significantly lower performance; for the Dichotic of Digits test, there was an interactive effect between the three groups (p < 0.001), with the ADHD group presenting a lower performance, followed by the dyslexic and control groups; for the Frequency Pattern, there was a marginal effect (p = 0.056) with the ADHA group presenting a lower performance, followed by the dyslexic and control groups.

CONCLUSION

the ADHD group presented a poorer performance in all tests when compared to the dyslexic and control groups. This result suggests a relationship between attention and hearing abilities.

Computerized Administration and Scoring of the Dichotic Nonsense Syllable Test

Purpose

A user-friendly computer program was designed to administer the dichotic nonsense syllable test (DNST). Computer automation makes it easier for listeners to perform the response task appropriately and for audiologists to administer and accurately score the test.

Method

The program presents test stimuli in a user-controlled, self-paced sequence; provides an easy-to-use client interface to collect listener responses; verifies that appropriate responses are recorded before proceeding with the test; scores responses automatically; and stores the information in an electronic format that is easy to analyze and archive.

Results

The automated DNST protocol is described. Verification tests confirm the accuracy of stimulus sequencing, response recording, and test scoring.

Conclusions

Computer automation makes administering the DNST easier, ensures the accuracy of test scoring, and simplifies the analysis and archiving of results. These refinements may make the DNST more useful to clinicians. Further research is required to establish normative data for this version of the DNST.

Auditory processing assessment in older people with no report of hearing disability

In the elderly, the results of central auditory pathways behavioral assessments are considered to be difficult to read because of the possible interference of peripheral auditory pathway involvement. Aim: Assess the efficacy of the central auditory function in elderly patients who do not complain of hearing. Materials and Methods: Case study involving 40 individuals within the age range of 60 to 75 years. The patients underwent auditory processing evaluation based on anamnesis, otorhinolaryngological exam, threshold tonal audiometry, speech recognition threshold, speech recognition index, immittance measures, stapes reflex study, synthetic phrases identification test with ipsilateral competitive message, frequency pattern test and alternate twin-syllable test through dichotic task; age range and hearing loss influenced results from the phrases identification with ipsilateral competitive message. Percentages of right answers below normal standards were seen in the three tests that assessed the central auditory functions. Conclusion: Elderly individuals who did not complain of hearing presented relevant prevalence of signs of central auditory function inefficiencies.

Development of auditory processing in 6–12-year-old children: a longitudinal study

The development of auditory processing in children was investigated in a longitudinal study. A group of 20 children with normal cognitive and language development underwent several auditory tests at the ages of 6, 7, 8, 10 and 12 years. At the age of 10 years, three subjects were lost to follow-up, as was one more subject at the age of 12 years. The auditory performance of the children was compared to the performance of a group of 20 adults. The auditory test battery consisted of a speech-in-noise test, a filtered speech test, a binaural fusion test and two auditory sequencing tests. At the ages of 6, 7 and 8 years, data on the performance on an auditory word discrimination test, an auditory synthesis test, an auditory closure test and a number recall test were also obtained. All auditory tests except the speech-in-noise test showed a clear effect of age on the performance of children. Our data suggest that maturational effects play an important role in auditory processing (at least) up to an age of 12-13 years. Correlations between the tests are in general not indicative of large amounts of overlap between the different tests. Factor analysis shows that three factors account for 68-70% of explained variance, with the three factors contributing equally. A composite score obtained by averaging all (sub)test scores can be used next to the individual test scores to describe the development of auditory processing abilities in children.

Development of an auditory test battery for young children: a pilot study

This article describes the development and results of a pilot study with a recently developed auditory test battery for 4-6-year-old Dutch children. The test battery consisted of a sustained auditory attention (SAA) test, a dichotic words (DW) test, a binaural masking-level difference (BMLD) test, an auditory word discrimination (AWD) test, a gap detection (GD) test and a test of phonemic awareness, the Lindamood Auditory Conceptualization (LAC) test. Our results show that this test battery can be administered successfully to children aged 4 years and older. Most tests showed a clear effect of chronological age; the strongest age effects were found for the DW test and the LAC test. The BMLD test was the only test for which no significant age effect was found in this group of children. A small, but significant right-ear advantage was found on the DW test, for the 4- and the 6-year-olds. Correlations between subtests were in general rather high, suggesting that several tests in this test battery may be tapping into similar auditory abilities.

Assessment of auditory processing in 6-year-old language-impaired children: Evaluacion del procesamiento auditivo en niños de 6 años con trastornos del lenguaje

The performance of a group of twenty 6-year-old children with specific language impairment (SLI) on several behavioural auditory tests was compared to that of a group of twenty age-matched control children. The auditory test battery used in this study consisted of the following tests: a speech-in-noise test, a filtered speech test, a binaural fusion test, a frequency pattern test, a duration pattern test, a temporal integration test, an auditory word discrimination test, an auditory synthesis test, an auditory closure test and a number recall test. Our results show that the SLI children obtained scores on almost all tests that were significantly lower than those of the control group. Many of the basic auditory processing measures in our test battery correlated significantly with receptive and language scores, suggesting a (causal) relationship between auditory processing and language proficiency. Results from discriminant function analyses do not warrant deleting one or more tests from the test battery yet (with the exception of the auditory synthesis test and the temporal integration test, for which we did not find significant group effects). At present, we are conducting experiments with older (SLI and control) children and adults to find whether the significant performance deficits of the SLI children are also found in older SLI children, and to determine the influence of maturational effects on these auditory tests.

Comorbidity of auditory processing, language, and reading disorders

PURPOSE

The authors assessed comorbidity of auditory processing disorder (APD), language impairment (LI), and reading disorder (RD) in school-age children.

METHOD

Children (N = 68) with suspected APD and nonverbal IQ standard scores of 80 or more were assessed using auditory, language, reading, attention, and memory measures. Auditory processing tests included the Frequency Pattern Test (FPT; F. E. Musiek, 1994; D. Noffsinger, R. H. Wilson, & F. E. Musiek, 1994); the Dichotic Digit Test Version 2 (DDT; F. E. Musiek, 1983); the Random Gap Detection Test (R. W. Keith, 2000); the 500-Hz tone Masking Level Difference (V. Aithal, A. Yonovitz, & S. Aithal, 2006); and a monaural low-redundancy speech test (compressed and reverberant words; A. Boothroyd & S. Nittrouer, 1988). The Clinical Evaluation of Language Fundamentals, Fourth Edition (E. Semel, E. Wiig, & W. Secord, 2003) was used to assess language abilities (including auditory memory). Reading accuracy and fluency and phonological awareness abilities were assessed using the Wheldall Assessment of Reading Passages (A. Madelaine & K. Wheldall, 2002) and the Queensland University Inventory of Literacy (B. Dodd, A. Holm, M. Orelemans, & M. McCormick, 1996). Attention was measured using the Integrated Visual and Auditory Continuous Performance Test (J. A. Sandford & A. Turner, 1995).

RESULTS

Of the children, 72% had APD on the basis of these test results. Most of these children (25%) had difficulty with the FPT bilaterally. A further 22% had difficulty with the FPT bilaterally and had right ear deficits for the DDT. About half of the children (47%) had problems in all 3 areas (APD, LI, and RD); these children had the poorest FPT scores. More had APD-RD, or APD-LI, than APD, RD, or LI alone. There were modest correlations between FPT scores and attention and memory, and between DDT scores and memory.

CONCLUSIONS

LI and RD commonly co-occur with APD. Attention and memory are linked to performance on some auditory processing tasks but only explain a small amount of the variance in scores. Comprehensive assessment across a range of areas is required to characterize the difficulties experienced by children with APD.

Avaliação do processamento auditivo em idosos que relatam ouvir bem

Em idosos, os resultados da avaliação comportamental das vias auditivas centrais são considerados de difícil interpretação devido à possível interferência do comprometimento das vias auditivas periféricas. OBJETIVO: Avaliar a eficiência das funções auditivas centrais de idosos que relatam ouvir bem. MATERIAL E MÉTODO: Estudo de casos que incluiu 40 indivíduos na faixa etária de 60 a 75 anos. Os pacientes foram submetidos à avaliação do processamento auditivo que constou de anamnese, exame otorrinolaringológico, audiometria tonal liminar, limiar de reconhecimento de fala, índice de reconhecimento de fala, imitanciometria, pesquisa de reflexos estapedianos, teste de identificação de sentenças sintéticas com mensagem competitiva ipsilateral, teste de padrões de freqüência e teste de dissílabos alternados por meio de tarefa dicótica. RESULTADOS: Gênero, faixa etária e perda auditiva não influenciaram os resultados dos testes de padrões de freqüência e dissílabos alternados por meio de tarefa dicótica; faixa etária e perda auditiva influenciaram os resultados do teste de identificação de sentenças com mensagem competitiva ipsilateral. Porcentagens de acertos abaixo dos padrões da normalidade de adultos foram observadas nos três testes que acessam as funções auditivas centrais. CONCLUSÃO: Indivíduos idosos que relatam ouvir bem apresentam prevalência relevante de sinais de ineficiência das funções auditivas centrais.

Comparative study between school performance on first grade children and suppression of otoacoustic transient emission

Aim

Material and Methods

Results

Conclusion

Deciphering auditory processing disorders in children

APD is not a label for a unitary disease entity but rather a description of functional deficits [3]. It is a complex and heterogeneous group of auditory-specific disorders usually associated with a range of listening and learning deficits [3,4]. Underlying APD is a deficit observed in one or more of the auditory processes responsible for generating the auditory evoked potentials and the following behaviors: around localization and lateralization; auditory discrimination; auditory pattern recognition; temporal aspects of audition, including temporal resolution, masking, integration, and ordering; auditory performance with competing acoustic signals; and auditory performance with degraded acoustic signals [2]. Comprehensive assessment is necessary for the accurate differential diagnosis of APD from other "look-alike" disorders, most notably ADHD and language processing disorders. Speech-language pathologists, psychologists, educators, and physicians contribute to this more comprehensive assessment. The primary role of otolaryngologists is to evaluate and treat peripheral hearing disorders, such as otitis media. Children with APDs may present to an otolaryngologist, thus requiring the physician to make appropriate referral for assessment and intervention. Currently, diagnosis of APD is based on the outcomes of behavioral tests, supplemented by electroacoustic measures and, to a lesser extent, by electrophysiologic measures [1]. Intervention for APD focuses on improving the quality of the acoustic signal and the listening environment, improving auditory skills, and enhancing utilization of metacognitive and language resources [2]. Additional controlled case studies and single-subject and group research designs are needed to ascertain systematically the relative efficacy of various treatment and management approaches.

A new CAPD battery--multiple auditory processing assessment: factor analysis and comparisons with SCAN

Based on recommendations by Musiek & Chermak (1994, American Journal of Audiology, 3, 23-27) and ASHA (1996, American Journal of Audiology, 5(2), 41-54), a battery of four commonly used tests was selected and recorded for use in assessing school children. These tests were labeled the Multiple Auditory Processing Assessment (MAPA) and then administered to an initial sample of 81 third grade children, along with the SCAN screening test for auditory processing disorders. Afterward, several exploratory factor analyses were performed on the findings, and comparisons were made between the results for the MAPA and SCAN. Four separate factors emerged from the four MAPA tests, which were linked closely to the components of central auditory processing disorders (CAPDs) defined by ASHA (1996, American Journal of Audiology, 5(2), 41-54). These factors were labeled monaural separation/closure (MSC), auditory pattern/temporal ordering, binaural integration, and binaural separation (BS). SCAN appears to measure two of these factors, MSC and BS. Use of MAPA is encouraging. Our findings suggest it may provide an appropriate multiple-test, CAPD battery for third grade children, and it meets at least some of the objectives described in the consensus document proposed by ASHA (1996, American Journal of Audiology, 5(2), 41-54).

Central auditory processes and test measures: ASHA 1996 revisited

The theoretical issues surrounding central auditory processing disorders (CAPD) are reviewed here, especially with reference to the central auditory behavioral processes and the auditory test measures as prescribed in the ASHA (1996, American Journal of Audiology, 5(2), 41-54) statement on CAPD. A simplified nomenclature is recommended that directly relates process and test measure to facilitate the diagnostic process in CAPD. This new terminology closely follows the ASHA (1996, American Journal of Audiology, 5(2), 41-54) document, but provides some refinement based on recent research in CAPD. To support this recommendation, a confirmatory factor analysis (CFA) was applied to the findings of Domitz and Schow (2000, American Journal of Audiology), who proposed use of a battery of CAPD tests, the Multiple Auditory Processing Assessment (MAPA) for testing school children. The CFA was found to reinforce the four-factor model, which clearly emerged in the exploratory factor analysis of Domitz and Schow. The model was found to be reasonably consistent even when subtests from the SCAN were included in the analysis. Refinement and revision of ASHA (1996, American Journal of Audiology, 5(2), 41-54) is recommended to facilitate diagnosis, subclassification, and intervention for CAPD.

Effects of methylphenidate (Ritalin) on auditory performance in children with attention and auditory processing disorders

A double-blind, placebo-controlled study was used to investigate the effects of methylphenidate (Ritalin) on tests of auditory processing in children diagnosed with both Attention Deficit Hyperactivity Disorder (ADHD) and Central Auditory Processing Disorder (CAPD). Thirty-two subjects received three Central Auditory Processing (CAP) tests and the Auditory Continuous Performance Test (ACPT), a measure of attention/impulsivity, at two separate test sessions: once when medicated with Ritalin and once when nonmedicated (placebo). Sixteen subjects were assigned randomly to receive their medication first and 16 to receive the placebo first. A counterbalanced 2 x 2 mixed factorial analysis of variance was conducted for each of the four dependent variables: Staggered Spondaic Word (SSW), Phonemic Synthesis (PS), Speech-in-Noise (SN), and ACPT measures. Analyses revealed that Ritalin did not have a significant effect on any of the three CAP measures. However, ACPT performance was significantly better (p < .000) for the Ritalin versus placebo condition.

Implications from factor analysis for central auditory processing disorders

Central auditory processing disorders among school-age children have been challenging to identify and treat. Many issues remain that need to be resolved. Here, we compare and contrast findings on 331 school-age children who were given two of the more common central auditory processing disorder tests (Staggered Spondaic Word [SSW] Test and the SCAN Screening Test for Auditory Processing Disorders). These results replicate and reinforce many of the psychometric findings reported earlier. The use of factor analysis with these test results was explored. Significantly, two factors emerged, including an auditory binaural separation from competition factor and a monaural low redundancy degradation factor. These findings help us define the nature of processes probed by the SCAN screening test and the SSW test. Furthermore, these findings clarify the use of SSW and SCAN because they showed both SSW Left Competing and Right Competing loading within the same factor, whereas the three subtests on SCAN sorted into two rather than three factors.

SCAN test-retest reliability for first- and third-grade children

The SCAN is a popular screening test that was developed to provide a rapidly administered, standardized method for determining the potential of central auditory processing disorder (CAPD) in children between the ages of 3 and 11 years. It can be administered in 20 minutes with a portable stereo cassette player and contains three subtests: filtered words (FW), auditory figure ground (AFG), and competing words (CW). Published SCAN test-retest reliability data (Keith, 1986) used a 6-month retest interval and indicated that SCAN scores may be unreliable. No additional reliability data are available, and studies indicate that SCAN has been used by both researchers and clinicians despite reliability concerns. This investigation examined the stability of SCAN outcomes for 25 first-grade and 22 third-grade children (ages 6 to 9 years) using a 6- to 7-week retest interval. Time of day and examiner were held constant, and participants were normal-hearing, were Caucasian, and spoke English as their primary language. ANOVA outcomes indicated that both raw and standard scores improved significantly from Test 1 to Test 2 for two of the three SCAN subtests (FW and CW) and for the composite (COMP) score. Additionally, COMP-percentile-rank and age-equivalent outcomes demonstrated significant improvement from test to retest for both grades. The AFG subtest was the only SCAN measure for which a significant test-retest difference did not emerge. The highest test-retest correlation values (r) were moderately strong (0.70 < or = r < or = 0.78) and occurred for the CW and COMP scores. Implications of correlations and factor analyses are discussed. It is suggested that examiners base recommendations for additional testing, follow up, and remediation on the COMP score only. Further, it appears that second administration of the SCAN can provide a better estimate of an individual child's best performance, but lack of second-score norms confounds simple interpretation of such scores.