Auditory Processing Disorder (APD) in Children

APD tests and criteria

Referrals for APD evaluation from teachers, psychologists, speech-language pathologists, and other professionals are increasing, and parents are demanding appropriate services when they learn of the existence of APD on the Internet and other media sources.  Yet, despite the need for APD assessment and the availability of behavioural assessments, many audiologists have been reluctant to include APD assessment in their clinical practices (Kraus and Anderson, 2016)

Intervention programmes

Neuroplasticity underpins auditory training and requires that activities are sufficiently challenging (i.e. at the ‘edge of competence’) and repeated over extended periods of time to be likely to be effective (for example, 30 minutes, 3-4 times a week for 6 weeks).

Audiogram and baseline tests

Prior to considering administering any tests of auditory processing it is important to do ear specific audiometry (250-8000Hz) and, if possible, up to 12,000Hz and immittance (tympanometry and reflexes) to rule out peripheral hearing loss and middle ear dysfunction.

There is some evidence to suggest that contralateral acoustic reflexes can be absent for some children with APD although this has recently been challenged by Kunze et al (2017).

Multi- or interdisciplinary team

A multi- or interdisciplinary team is needed given the overlap between APD and other developmental disorders/delays.

Controversy surrounding APD

Referrals for APD evaluation from teachers, psychologists, speech-language pathologists, and other professionals are increasing, and parents are demanding these services when they learn of the existence of APD on the Internet and other media sources.  Yet, despite the need for APD assessment and the availability of behavioural assessments, many audiologists have been reluctant to include APD assessment in their clinical practices (Kraus and Anderson, 2016).

Kraus and Anderson (2016) identify several factors that contribute to this reluctance:

References

References

American Academy of Audiology. (2010). Diagnosis, treatment and management of children and adults with central auditory processing disorder [Clinical Practice Guidelines].

American Academy of Audiology. (2010). Auditory Integration Training: Position Statement.

Technology

Here are some of the most helpful technologies for auditory processing disorder:

Questionnaires

Any discussion about the utility of questionnaires or checklists to screen for APD needs to be based on the knowledge that there is no gold standard for how APD is defined, the tests that should used or the criteria for diagnosis.  This reduces the certainty with which sensitivity and specificity can be identified.  It has been suggested that the utility of questionnaires and APD tests be “derived from patients with known, anatomically confirmed central auditory dysfunction and used as a guide to identify the presence of central auditory dysfunction in children and adults suspected of (

Watch out for APD look-a-likes

There are other disorders that can present with similar ‘symptoms’ as APD.  The intervention required may however be different.  Differential diagnosis is thus crucial.

It is important to identify/rule out the following disorders:

Unilateral (one sided) hearing loss

‘Bottom up’ and ‘top down’

As discussed under the section What is APD?’ there are both ‘bottom up’ and ‘top down’ processes involved.

Auditory information is not only relayed on up to the brain it is also ‘shaped’ or modulated by the brain as part of the process. Higher cognitive functions that play a role in ‘shaping’ the incoming auditory information include aspects such as language, attention and memory.

Pages

Subscribe to RSS - Auditory Processing Disorder (APD) in Children