Deficits in Auditory Rhythm Perception in Children With Auditory Processing Disorder Are Unrelated to Attention

Absence of Rhythm Benefit on Speech in Noise Recognition in Children Diagnosed With Auditory Processing Disorder

Auditory processing disorder (APD) is a specific deficit in the processing of auditory information along the central auditory nervous system. It is characterized mainly by deficits in speech in noise recognition. APD children may also present with deficits in processing of auditory rhythm. Rhythmic neural entrainment is commonly present in perception of both speech and music, while auditory rhythmic priming of speech in noise has been known to enhance recognition in typical children. Here, we test the hypothesis that the effect of rhythmic priming is compromised in APD children, and further assessed for correlations with verbal and non-verbal auditory processing and cognition. Forty APD children and 33 neurotypical ones were assessed through (a) WRRC, a test measuring the effects of rhythmic priming on speech in noise recognition, (b) a battery of auditory processing tests, commonly used in APD diagnosis, and (c) two cognitive tests, assessing working memory and auditory attention respectively. Findings revealed that (a) the effect of rhythmic priming on speech in noise recognition is absent in APD children, (b) it is linked to non-verbal auditory processing, and (c) it is only weakly dependent on cognition. We discuss these findings in light of Dynamic Attention Theory, neural entrainment and neural oscillations and suggest that these functions may be compromised in APD children. Further research is needed (a) to explore the nature of the mechanics of rhythmic priming on speech in noise perception and why the effect is absent in APD children, (b) which other mechanisms related to both rhythm and language are also affected in this population, and (c) whether music/rhythm training can restore deficits in rhythm effects.

On differentiating auditory processing disorder (APD) from attention deficit disorder (ADD): an illustrative example using the Cattell-Horn-Carroll (CHC) model of cognitive abilities

Objective: To clarify the distinction between Auditory Processing Disorder (APD) and Attention Deficit Disorder (ADD) using the CHC Model.Design: A cross-sectional study compared responses of caregivers about their children's behaviour to identify characteristics of APD (CHC Model) and ADD (DSM-5).Study Sample: Caregivers, mostly mothers (92%), of 149 children (M 61%; F 39%) aged from 6 to 16 years, referred for "Auditory Processing Assessment" of their child, were shown an A4 card displaying the characteristics of AP from the CHC Model on one side, and of ADD from DSM-5 on the other. Both sides were untitled. For each side, caregivers were asked if the characteristics were true of their child using a Conners-type four-point scale.Results: The majority of children were rated by caregivers as displaying characteristics of ADD, rather than an APD problem. Comparing problems with AP vs. problems with ADD gave: Wilcoxon T = 9.71; z = 4.86, p < 0.001.Conclusion: The finding that most children referred for an AP Assessment showed characteristics of ADD was surprising. Given the continuing audiological controversies about the nature of AP and about differentiating AP disorders from ADD, the CHC Model offers a different and informative perspective.

Clinical Expertise Is Core to an Evidence-Based Approach to Auditory Processing Disorder: A Reply to Neijenhuis et al. 2019

The opinion article "An Evidence-based Perspective on Misconceptions Regarding Pediatric Auditory Processing Disorder" by Neijenhuis et al. (1) presents a distorted view of the evidence-based approach used in medicine. The authors focus on the amorphous non-diagnostic entity "listening difficulties" not auditory processing disorder (APD) and create confusion that could jeopardize clinical services to individuals with APD. In our perspective article, we rebut Neijenhuis et al. (1), and more importantly, we present a rationale for evidence-based practice founded on the premise that research on APD is only clinically applicable when conducted on clinical populations diagnosed with APD.