Central auditory processing disorder and ADHD

Characteristics of Speech Auditory Brainstem Response in Preschool Children With Attention-Deficit/Hyperactivity Disorder

OBJECTIVE

This study aimed to investigate the characteristics of auditory processing (AP) in preschool children with attention-deficit/hyperactivity disorder (ADHD) using the speech auditory brainstem response (speech-ABR), which provides insights into the AP of speech signals in the central auditory nervous system (CANS).

METHOD

A total of 84 preschool children diagnosed with ADHD, aged 4-6 years, were matched with 84 typically developing (TD) children based on gender and age. All children underwent speech-ABR testing, cognitive assessment using the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition or the Wechsler Intelligence Scale for Children-Fourth Edition, and a continuous performance test.

RESULTS

Children with ADHD exhibited significantly longer latencies of speech-ABR waveforms V, A, and D compared to TD children. Multiple linear regression analysis showed that the latencies of speech-ABR waves V, A, and D were affected by the presence of ADHD, but not by the full-scale intelligence quotient.

CONCLUSIONS

This study revealed that preschool children with ADHD exhibited abnormal AP of speech signals in their CANS. The findings suggest that speech-ABR can be utilized as a reliable measure to evaluate AP ability in this population, as it remains unaffected by cognitive or attentional factors. The transient response (V, A) of speech-ABR was found to be a significant predictor of ADHD in a clinical setting. Early assessment of AP abnormalities via speech-ABR is recommended in preschool-age children to develop targeted interventions for ADHD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.26376502.

[Application of Preschool Auditory Processing Assessment Scale in children with attention deficit hyperactivity disorder]

OBJECTIVES

To investigate the characteristics of auditory processing (AP) in preschool children with attention deficit hyperactivity disorder (ADHD) using Preschool Auditory Processing Assessment Scale (hereafter referred to as "auditory processing scale").

METHODS

A total of 41 children with ADHD and 41 typically developing (TD) children were assessed using the auditory processing scale, SNAP-IV rating scale, and Conners' Kiddie Continuous Performance Test (K-CPT). The auditory processing scale score was compared between the TD and ADHD groups. The correlations of the score with SNAP-IV and K-CPT scores were assessed.

RESULTS

Compared with the TD group, the ADHD group had significantly higher total score of the auditory processing scale and scores of all dimensions except visual attention (P<0.05). In the children with ADHD, the attention deficit dimension score of the SNAP-IV rating scale was positively correlated with the total score of the auditory processing scale (rs30=0.531, P<0.05; rs27=0.627, P<0.05) as well as the scores of its subdimensions, including auditory decoding (rs=0.628, P<0.05), auditory attention (rs=0.492, P<0.05), and communication (rs=0.399, P<0.05). The hyperactivity-impulsivity dimension score of the SNAP-IV rating scale was positively correlated with the hyperactivity-impulsivity dimension score of the auditory processing scale (rs=0.429, P<0.05). In the children with ADHD, the attention deficit dimension score of the K-CPT was positively correlated with the total score (rs30=0.574, P<0.05; rs27=0.485, P<0.05) and the hyperactivity-impulsivity dimension score (rs=0.602, P<0.05) of the auditory processing scale.

CONCLUSIONS

Preschool children with ADHD have the risk of AP abnormalities, and the auditory processing scale should be used early for the screening and evaluation of AP abnormalities in children.

The Effect of Attention-Deficit/Hyperactivity Disorder and Methylphenidate Treatment on the Adult Auditory Temporal Order Judgment Threshold

PURPOSE

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition notes that attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood will persist into adulthood among at least some individuals. There is a paucity of evidence, however, regarding whether other difficulties that often accompany childhood ADHD will also continue into adulthood, specifically auditory processing deficits. The aim of this study was to examine the effect of ADHD and the stimulant medication methylphenidate on auditory perception performance among adults.

METHOD

A total of 33 adults diagnosed with ADHD according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria (ADHD group) and 48 adults without ADHD (non-ADHD group) performed an auditory temporal order judgment task. Participants with ADHD performed the task twice: with and without taking methylphenidate (Ritalin), in random order.

RESULTS

Temporal order judgment thresholds of the ADHD group were significantly higher than those of the non-ADHD group. Methylphenidate significantly decreased temporal order judgment thresholds within the ADHD group, making their performance similar to the non-ADHD participants.

CONCLUSIONS

Auditory processing difficulties of those diagnosed with ADHD seem to persist into adulthood. Similar to findings with children, methylphenidate treatment improves performance on tasks requiring this ability among adults. Therefore, given the association between auditory temporal processing and linguistic skills, the beneficial effect of methylphenidate on adults' academic achievement may be accomplished by positively affecting auditory temporal processing. Further studies in this line of research are needed.

Are We Yet Able to Hear the Signal Through the Noise? A Comprehensive Review of Central Auditory Processing Disorders: Issues of Research and Practice

A Central Auditory Processing Disorder (CAPD) exists when a child has apparent difficulty in processing auditory information while possessing normal hearing. CAPD has been implicated by some as the root disorder underlying learning disabilities, Attention Deficit/Hyperactivity Disorder, and Specific Language Impairment. Despite years of research there is little consensus on a definition, criteria for assessment and diagnosis, and the efficacy of remediation and management. This comprehensive review of the CAPD literature examines the prevalence and etiology, assessment methods, differential diagnosis, as wVell as methods of management and remediation. Particular attention is paid to the details of research design and psychometrics. Support for the distinct existence of CAPD would be aided by the development of a modality-specific operational definition, assessment tools that were better standardized and normed, and the use of better control conditions in research.

[Significance of auditory perceptual disorders for pediatric and adolescent psychiatric disorders]

The clinical relevance of central auditory processing disorders (CAPD) is highly controversial. The paper explicates different concepts of CAPD and reviews empirical studies of the relationship between auditory deficits and learning or psychiatric disorders. The overview of the available literature reveals that numerous authors have described subnormal auditory abilities in groups of children with developmental language disorders, dyslexia or ADHD. However, little or no relationship between the severity of clinical impairment and auditory deficits has been found. Thus auditory deficits do not appear to be causally related to learning disorders or conduct disorders. With respect to the diagnostic process the review makes clear that the validity of the diagnosis CAPD is low. There is no agreement about diagnostic criteria, and the reliability of most auditory tests in insufficient. Moreover, while an auditory training can only improve the directly trained auditory functions, there is no transfer effect to learning ability of behavior. Altogether there is little evidence for a significant relevance of CAPD in Child and Adolescent Psychiatry.