Comparison of listening efforts in typically developing children and children with central auditory processing disorders.

OBJECTIVES: The study's main objective was to compare Listening Effort (LE) in children with central auditory processing disorder [(C)APD] and typically developing children in quiet and at -2 and -6 dB SNR conditions. And to determine the relationship between LE and auditory processing abilities in children with (C)APD. METHODS: The study included 30 children (15 typically developing children and 15 diagnosed with (C)APD) aged 10-12 years. LE was measured using a dual-tasking paradigm. The primary task required the child to repeat the words. The second task required the child to click the mouse based on the image displayed on the laptop's screen. The primary task was done at quiet, -2 dB SNR, and -6 dB SNR conditions. LE was correlated with dichotic CV, duration pattern test, speech perception in noise - Indian English, and gap detection test in children with (C)APD. RESULTS: A mixed ANOVA was performed with LE in various conditions as the within-subject factor and group as the between-subject factor for both repetition and reaction time. The study found that LE repetition and reaction time had a significant main effect across conditions and groups. The correlation results revealed a significant relationship between LE reaction time with dichotic scores and GDT thresholds only at -2 dB SNR and -6 dB SNR conditions. There was no significant correlation between other auditory processing abilities and LE under different conditions, such as quiet, SPIN-IE, and DPT at -2 dB SNR and -6 dB SNR. CONCLUSION: The study emphasizes the importance of cognitive abilities for adequate listening comprehension in challenging situations. As a result, assessing LE in this population may provide additional information for developing therapeutic activities and assisting the child in overcoming listening difficulties.

A Characterization of Central Auditory Processing in Parkinson's Disease.

Background: Research indicates that people with Parkinson's disease (PwPs) may experience challenges in both peripheral and central auditory processing, although findings are inconsistent across studies. Due to the diversity of auditory measures used, there is a need for standardized, replicable hearing assessments to clarify which aspects of audition are impacted in PWPs and whether they are linked to motor and non-motor symptoms. Objective: To characterize auditory processes and their possible alteration in PwPs. To address this, we collected a comprehensive set of standardized measures of audition using PART, a digital testing platform designed to facilitate replication. Additionally, we examined the relationship between auditory, cognitive, and clinical variables in PwPs. Methods: We included 44 PwPs and 54 age and education matched healthy controls. Assessments included detection of diotic and dichotic frequency modulation, temporal gaps, spectro-temporal broad-band modulation, and speech-on-speech masking. Results: We found no statistically significant differences in auditory processing measures between PwPs and the comparison group (ps > 0.07). In PwPs, an auditory processing composite score showed significant medium size correlations with cognitive measures (0.39 < r<0.41, ps < 0.02) and clinical variables of motor symptom severity, quality of life, depression, and caretaker burden (0.33 < r<0.52, ps < 0.03). Conclusions: While larger datasets are needed to clarify whether PwPs experience more auditory difficulties than healthy controls, our results underscore the importance of considering auditory processing on the symptomatic spectrum of Parkinson's disease using standardized replicable methodologies.

It is unknown whether there exists a relationship between Parkinson's disease (PD) and hearing ability. While some studies have found hearing difficulties to be associated with PD, other studies failed to replicate these effects. We suggest that a possible reason for these differing findings are differences in how hearing is measured. To clarify the literature, we tested a group of people with Parkinson's (PwPs) on several aspects of hearing using a freely available tablet-based app. We compared PwPs hearing tests to those of an age and education matched group of people without PD. While we found no clear differences among the groups, we did find better hearing abilities were related to less motor symptom severity and depression, better reported quality of life, and less reported burden of the disease experienced by the caretaker. We conclude that while there is no solid evidence showing the hearing is necessarily impaired in PD, that measuring hearing in PwPs can provide valuable clinical information. This can inform new approaches to treatment for people living with PD such as those related with improving hearing.

A Multi-Sample Comparison and Rasch Analysis of the Evaluation of Children's Listening and Processing Skills Questionnaire.

OBJECTIVES: Assessing listening difficulties and associated complaints can be challenging. Often, measures of peripheral auditory functions are within normal ranges, making clinicians feel unsure about proper management strategies. The range and nature of observed or experienced difficulties might be better captured using a qualitative measure. The Evaluation of Children's Listening and Processing Skills (ECLiPS) questionnaire was designed to broadly profile the auditory and cognitive problems often present in children with listening difficulties. This 38-item questionnaire was initially standardized in British children aged 6 to 11 years, was subsequently modified for use with North-American children, and was recently translated into Flemish-Dutch. This study aimed to compare typical scores of the Flemish version with the UK and US versions, and to evaluate and compare its psychometric quality based on Rasch analysis. DESIGN: We selected 112 Flemish children aged 6 to 11 years with verified normal hearing and typical development, and asked two caregivers of every child to fill out the ECLiPS. Data from two comparator samples were analyzed, including responses for 71 North-American children and 650 British children. Typical values for ECLiPS factors and aggregates were determined as a function of age and gender, and meaningful differences across samples were analyzed. Rasch analyses were performed to evaluate whether ECLiPS response categories work as intended, and whether item scores fit a linear equal interval measurement scale that works the same way for everyone. Item and person metrics were derived, including separation and reliability indices. We investigated whether items function similarly across linguistically and culturally different samples. RESULTS: ECLiPS scores were relatively invariant to age. Girls obtained higher scores compared with boys, mainly for items related to memory and attention, and pragmatic and social skills. Across ECLiPS versions, the most pronounced differences were found for items probing social skills. With respect to its psychometric quality, ECLiPS response categories work as intended, and ECLiPS items were found to fit the Rasch measurement scale. Cultural differences in responses were noted for some items, belonging to different factors. Item separation and reliability indices generally pointed toward sufficient variation in item difficulty. In general, person separation (and reliability) metrics, quantifying the instrument's ability to distinguish between poor and strong performers (in a reproducible manner), were low. This is expected from samples of typically developing children with homogeneous and high levels of listening ability. CONCLUSIONS: Across the languages assessed here, the ECLiPS caregiver questionnaire was verified to be a psychometrically valid qualitative measure to assess listening and processing skills, which can be used to support the assessment and management of elementary school children referred with LiD.

Normative values for tests of central auditory processing disorder in children aged from 6 to 12 years old.

INTRODUCTION: Central auditory processing disorders (CAPD) can significantly affect the daily functioning of a child, and the first step in determining whether rehabilitation procedures are required is a proper diagnosis. Different guidelines for making diagnoses have been published in the literature, and in various centers normative values for psychoacoustic tests of CAPD have been used internally. The material presented in this paper is based on more than 1000 children and is the largest collection so far published. The aim of this study is to present normative values for tests assessing CAPD in children aged 6 to 12 years, divided by age at last birthday. METHOD: We tested 1037 children aged 6 to 12 years who were attending primary schools and kindergartens. The criteria for inclusion were a normal audiogram, intellectually normal, no developmental problems, and no difficulties in auditory processing. To evaluate auditory processing all children were given three tests on the Senses Examination Platform: the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Dichotic Digit Test (DDT). RESULTS: The results from 1,037 children allowed us to determine normative values for FPT, DPT, and DDT in seven different age groups (6 through to 12 years). We developed a newapproach, based on quantile-based norms, to determine normative values in each group. Three categories - average, below-average, and above-average - allow for a broader but more realistic interpretation than those used previously. We compare our results with published standards. CONCLUSIONS: Our study is the largest normative database published to date for CAPD testing, setting a standard for each child by age in years. We used the Senses Examination Platform, a universal tool, to unify standards for the classification of CAPD. Our study can serve as a basis for the development of a Polish model for the diagnosis of CAPD.

Relationship Between Cognitive Abilities and Basic Auditory Processing in Young Adults.

PURPOSE: The diagnosis of auditory processing disorder (APD) is controversial particularly due to the influence of higher order factors of language and cognition on the diagnostic APD testing. As a result, there might be a need for testing for other domains (e.g., cognition) along with conducting the diagnostic APD testing to rule out the influence of other domains. In order to make recommendations on whether cognitive testing is needed along with the auditory processing testing, as a starting point, the current study was conducted to examine the relationship between cognitive abilities and basic auditory processing in young adults. METHOD: A total of 38 young adults with normal audiometric thresholds between 250 and 8000 Hz participated in this study. They were tested on their executive function, language, processing speed, working memory, and episodic memory components of cognitive testing and tests for temporal fine structure and spectrotemporal sensitivity for auditory processing testing. RESULTS: No significant correlation was found between the cognitive tests and the tests for basic auditory processing in young adults. CONCLUSIONS: These findings present contrast to the existing findings in children and older adults where a stronger correlation between cognitive abilities and auditory processing has been found. The current findings suggest that testing for cognitive abilities may not be needed when testing for basic auditory processing in young adults.

Survey of students and guardians for assessing the early detection of auditory processing disorder and listening difficulties in school-age students.

OBJECTIVE: Auditory processing disorders (APD) and listening difficulties (LiD) are becoming increasingly prevalent in young adults. Our study surveyed students and their guardians to assess the early detection of APD and LiDs in students aged 6-18 years. We estimated the percentage of students with LiDs and assessed their guardians' perceptions during different school years. METHODS: This prospective study enrolled students from schools affiliated with Osaka Kyoiku University and their guardians. Both students and their guardians completed a basic assessment on demographics, and a questionnaire assessing LiD (completed by both students and guardians) and developmental problems (completed only by guardians). LiD was assessed in the following four domains: (i) auditory attention, (ii) auditory memory, (iii) auditory discrimination, and (iv) auditory restoration. The relationship between the school-year group and the total score for LiD and the differences between the students' and guardians' perceptions of the association between the school-year group and LiD domains were examined. RESULTS: Respondents comprised 743 students from 120 classes at three schools and 743 guardians. Hearing loss was reported by 26.5% of students and 26.1% of their guardians, with the majority indicating slight hearing loss. Compared with the students, their guardians more commonly indicated a normal response to all the questions related to LiD. The LiD scores reported by students increased with increasing school years and significantly deviated from those reported by their guardians. The students' scores in the auditory attention and auditory memory domains demonstrated significant increase with increasing school years, with the greatest increase in the auditory attention category. CONCLUSIONS: Students reported increasing severity of LiD with increasing school years, whereas their guardians underreported such symptoms, most significantly in the later school years. Therefore, screening for symptoms related to auditory attention could aid in the early detection of APD and LiD in school-age children.

Evaluation of cognitive functions in the elderly with and without central auditory processing disorder. / Avaliação das funções cognitivas em idosos com e sem alterações no processamento auditivo central.

PURPOSE: Evaluate and compare the performance of cognitive functions between elderly with and without auditory processing disorders. METHODS: Twenty-eight healthy elderly (14 Control group and 14 Auditory Processing Disorder group - APD group) participated in the study. All elderly were submitted to (central) auditory processing evaluation, P300 event-related potential and brief cognitive battery (BCB). In the comparison between subjects, the Mann-Whitney test was applied and in the intra-subjects comparison, the Wilcoxon signed rank test was used. To verify if there was an association between the performance of the PAC and the cognitive variables, Spearman's correlation was used. RESULTS: There were no statistically significant differences between the Control and APD groups for the cognitive abilities assessed by BCB, as well as for the P300 cognitive potential variables. CONCLUSION: Elderly with auditory processing disorders do not seem to show greater cognitive difficulties compared to elderly of the same age group without auditory processing disorders, exception of the clock drawing test, whose task involves multiple cognitive functions, including visuospatial processing, executive function, semantic memory, and planning.

OBJETIVO: Avaliar e comparar as funções cognitivas entre idosos com e sem alteração do processamento auditivo central. MÉTODO: Vinte e oito idosos saudáveis (14 do grupo controle e 14 do grupo Transtorno do Processamento Auditivo Central - TPAC) participaram do estudo. Todos os idosos foram submetidos à bateria mínima de avaliação do processamento auditivo central (PAC), ao potencial auditivo cognitivo P300 e a bateria cognitiva breve (BCB). Na comparação entre sujeitos, foi aplicado o teste de Mann-Whitney e na comparação intra-sujeitos, utilizamos o teste de postos sinalizados de Wilcoxon. Para verificar se houve associação entre o desempenho do PAC e das variáveis cognitivas, foi utilizada a correlação de Spearman. RESULTADOS: Não houve diferenças estatisticamente significantes entre os grupos 'Controle' e TPAC para a maioria das habilidades cognitivas avaliadas por meio da BCB, bem como para as variáveis do potencial cognitivo P300. Contudo, houve diferença estatisticamente significante entre o desempenho do grupo 'Controle' e TPAC para a prova do desenho do relógio. Além disso, foi possível observar correlação entre o desempenho do teste do relógio e no TPF. CONCLUSÃO: Idosos com TPAC não apresentaram alteração na maior parte dos testes cognitivos, com exceção da prova do desenho do relógio, cuja tarefa envolve múltiplas funções cognitivas, incluindo processamento visuoespacial, função executiva, memória semântica e planejamento.

Auditory Processing Disorder: Protocols and Controversy.

PURPOSE: This study examined current auditory processing disorder (APD) protocols and audiologists' perspectives on the active debate seen in the literature regarding the status of APD as a unique disorder. METHOD: This study used a cross-sectional, nonexperimental survey design. The participants were 134 U.S. audiologists, representing diversity across experience level and work setting. RESULTS: Popular APD tests from prior surveys remain popular, and a few new tests have emerged. Most audiologists use diverse strategies to identify potential comorbid disorders as part of their APD protocol, including multidisciplinary assessment and referral to other specialists. Most participants disagreed with the assertion that APD is not a unique disorder; however, many also pointed out that patients' struggles with listening need to be the primary focus of APD assessment and management, regardless of the label of the disorder. Qualitative analysis of participant comments on the controversy yielded six themes: Clinical Experience, Comorbidity, Listening Skills, Literature Support, Overdiagnosis, and More Information Needed. CONCLUSION: Most participants consider APD to be a unique disorder, citing clinical experience and the literature for support; however, many also indicated APD is complicated by comorbidity and APD may be overdiagnosed.

A data-driven approach to identify a rapid screener for auditory processing disorder testing referrals in adults.

Hearing thresholds form the gold standard assessment in Audiology clinics. However, ~ 10% of adult patients seeking audiological care for self-perceived hearing deficits have thresholds that are normal. Currently, a diagnostic assessment for auditory processing disorder (APD) remains one of the few viable avenues of further care for this patient population, yet there are no standard guidelines for referrals. Here, we identified tests within the APD testing battery that could provide a rapid screener to inform APD referrals in adults. We first analyzed records from the University of Pittsburgh Medical Center (UPMC) Audiology database to identify adult patients with self-perceived hearing difficulties despite normal audiometric thresholds. We then looked at the patients who were referred for APD testing. We examined test performances, correlational relationships, and classification accuracies. Patients experienced most difficulties within the dichotic domain of testing. Additionally, accuracies calculated from sensitivities and specificities revealed the words-in-noise (WIN), the Random Dichotic Digits Task (RDDT) and Quick Speech in Noise (QuickSIN) tests had the highest classification accuracies. The addition of these tests have the greatest promise as a quick screener during routine audiological assessments to help identify adult patients who may be referred for APD assessment and resulting treatment plans.

Auditory assessment and central auditory processing script for preschool children. / Roteiro de avaliação auditiva e do processamento auditivo central para pré-escolares.

PURPOSE: To develop an assessment script to observe hearing and central auditory processing in preschool children. METHODS: To The script was prepared based on a search in the Scielo databases and in the library of a university in the state of São Paulo using the following keywords: "central auditory processing", "hearing and language", "auditory processing disorders", "auditory processing in preschool children", and "vocabulary assessment", resulting in the selection of fourteen articles and two books. Then, questions related to auditory development and a script for assessing central auditory processing were prepared. RESULTS: The script consists of eight parts, namely: Identification and Anamnesis, Information about Mother and Pregnancy, Complaints, Auditory Development, Language Development, Motor Development, Simplified Auditory Processing Evaluation and Behavioral Audiological Assessment. CONCLUSION: The script is essential, given the lack of screening instruments in the literature for central auditory processing in preschool children that thoroughly investigate the entire process that permeates the auditory and language development of children aged 43 to 47 months.

OBJETIVO: Construir um roteiro de avaliação para observação da audição e do processamento auditivo central em pré-escolares. MÉTODO: Para elaboração do roteiro, primeiramente realizou-se uma busca nas bases de dados Scielo e biblioteca de uma universidade no estado de São Paulo, com as palavras chaves: "processamento auditivo central", "audição e linguagem", "distúrbios do processamento auditivo", "processamento auditivo em pré-escolares", "avaliação do vocabulário", selecionando então quatorze artigos e dois livros. Foram estruturadas perguntas relacionadas ao desenvolvimento auditivo e um roteiro de avaliação do processamento auditivo central. RESULTADOS: O roteiro constitui-se de oito partes, sendo identificação e anamnese, dados maternos e de gestação, queixas, desenvolvimento auditivo, desenvolvimento de linguagem, desenvolvimento motor, Teste auditivo comportamental para avaliação do processamento auditivo central e avaliação audiológica comportamental. CONCLUSÃO: O roteiro é de extrema importância visto que não há na literatura instrumentos de triagem de processamento auditivo em pré-escolares que investigue, de forma minuciosa, todo o processo que permeia o desenvolvimento auditivo e de linguagem de crianças de 43 a 47 meses.

Tone Deafness in Music Does Not Preclude Distributional Learning of Nonnative Tonal Languages in Individuals With Congenital Amusia.

PURPOSE: Previous studies have shown that individuals with congenital amusia exhibit deficient pitch processing across music and language domains. This study investigated whether adult Chinese-speaking listeners with amusia were still able to learn Thai lexical tones based on stimulus frequency of statistical distribution via distributional learning, despite their degraded lexical tone perception. METHOD: Following a pretest-training-posttest design, 21 amusics and 23 typical, musically intact listeners were assigned into bimodal and unimodal distribution conditions. Listeners were asked to discriminate minimal pairs of Thai mid-level tone and falling tone superimposed on variable base syllables and uttered by different speakers. The perceptual accuracy for each test session and improvement from pretest to posttest were collected and analyzed between the two groups using generalized mixed-effects models. RESULTS: When discriminating Thai lexical tones, amusics were less accurate than typical listeners. Nonetheless, similarly to control listeners, perceptual gains from pretest to posttest were observed in bimodally rather than unimodally trained amusics, as evidenced by both trained and nontrained test words. CONCLUSIONS: Amusics are able to learn lexical tones in a second or foreign context of speech. This extends previous research by showing that amusics' distributional learning of linguistic pitch remains largely preserved despite their degraded pitch processing. It is thus likely that manifestations of amusia in speech could not result from their abnormal statistical learning mechanism. This study meanwhile provides a heuristic approach for future studies to apply this paradigm into amusics' treatment to mitigate their pitch-processing disorder.

Distributional learning of musical pitch despite tone deafness in individuals with congenital amusia.

Congenital amusia is an innate and lifelong deficit of music processing. This study investigated whether adult listeners with amusia were still able to learn pitch-related musical chords based on stimulus frequency of statistical distribution, i.e., via distributional learning. Following a pretest-training-posttest design, 18 amusics and 19 typical, musically intact listeners were assigned to bimodal and unimodal conditions that differed in distribution of the stimuli. Participants' task was to discriminate chord minimal pairs, which were transposed to a novel microtonal scale. Accuracy rates for each test session were collected and compared between the two groups using generalized mixed-effects models. Results showed that amusics were less accurate than typical listeners at all comparisons, thus corroborating previous findings. Importantly, amusics-like typical listeners-demonstrated perceptual gains from pretest to posttest in the bimodal condition (but not the unimodal condition). The findings reveal that amusics' distributional learning of music remains largely preserved despite their deficient music processing. Implications of the results for statistical learning and intervention programs to mitigate amusia are discussed.

Behavioral assessment of auditory processing in adulthood: population of interest and tests - a systematic review. / Avaliação comportamental do processamento auditivo na idade adulta: população de interesse e testes - uma revisão sistemática.

PURPOSE: To identify the behavioral tests used to assess auditory processing throughout adulthood, focusing on the characteristics of the target population as an interest group. RESEARCH STRATEGIES: PubMed, CINAHL, Web of Science, and Scielo, databases were searched with descriptors: "auditory perception" or "auditory perception disorders" or "auditory processing" or "central auditory processing" or "auditory processing disorders" or "central auditory processing disorders" with adults OR aging. SELECTION CRITERIA: Studies with humans included, the adult population from 18 to 64 years old, who performed at least one behavioral test to assess auditory processing in the absence of hearing loss. DATA ANALYSIS: Data extraction was performed independently, using a protocol developed by the authors that included different topics, mainly the behavioral auditory tests performed and the results found. RESULTS: Of the 867 records identified, 24 contained the information needed to answer the survey questions. CONCLUSION: Almost all studies were conducted verify performance in one or two auditory processing tests. The target target population was heterogeneous, with the most frequent persons with diabetes, stuttering, auditory processing disorder, and noise exposure. There is little information regarding benchmarks for testing in the respective age groups.

OBJETIVO: Identificar os testes comportamentais utilizados para a avaliação do processamento auditivo ao longo da vida adulta, com enfoque nas características da população alvo enquanto grupo de interesse. ESTRATÉGIA DE PESQUISA: As bases de dados consultadas foram o PubMed, CINAHL, Web of Science e Scielo, a partir dos descritores: "auditory perception" or "auditory perception disorders" or "auditory processing" or "central auditory processing" or "auditory processing disorders" or "central auditory processing disorders" com adults OR aging. CRITÉRIOS DE SELEçÃO: Incluiu-se estudos com humanos, que abordaram a população adulta de 18 a 64 anos, que realizaram pelo menos um teste comportamental para avaliação do processamento auditivo, na ausência de perda auditiva. ANÁLISE DOS DADOS: Realizou-se a extração de dados de forma independente, a partir de um protocolo desenvolvido pelos autores incluindo diferentes tópicos, principalmente os testes auditivos comportamentais realizados e os resultados encontrados. RESULTADOS: Dos 867 registros identificados, 24 foram selecionados como contendo as informações necessárias para responder às perguntas de pesquisa. CONCLUSÃO: Quase a totalidade dos estudos foi conduzida com objetivo de verificar o desempenho em um ou dois testes de processamento auditivo; a população alvo foi heterogênea, as mais frequentes foram diabetes, gagueira, transtorno do processamento auditivo e exposição ao ruído. Há poucas informações sobre os padrões de referência para os testes na respectiva faixa etária.

Screening for Auditory Processing Disorder in French-Speaking School-Age Children: A Pilot Study.

OBJECTIVES: A few clinical screening tools for auditory processing disorder (APD) are currently available. However, most of these tools are in English and cannot be used to screen individuals with a first language other than English. This study aimed to develop an APD screening test battery in French and to assess its psychometric properties in detecting school-age children at risk of APD. METHOD: Prior to their complete audiological APD assessment, 53 children (7-12 years old) were recruited from an audiology clinic. The APD assessment lasted between 2 and 3 hr, including 15-20 min for the screening test battery. The screening test battery was composed of four behavioral subtests and two questionnaires (parent and teacher). RESULTS: When combined, two among the four behavioral subtests showed a sensitivity of 100% and a specificity of 80%. CONCLUSION: The newly developed screening tool could help reduce the number of unnecessary APD assessments, therefore allowing early diagnosis in children with APD and increasing their chances of receiving adequate intervention.

Precisión diagnóstica de una versión abreviada de las pruebas de patrones de frecuencia y patrones de duración para la evaluación del ordenamiento auditivo temporal / Diagnostic accuracy of an abbreviated version of the frequency pattern and duration pattern tests for the evaluation of auditory temporal ordering

Introducción: Las pruebas de patrones de frecuencia y patrones de duración son consideradas los gold standard de evaluación del ordenamiento auditivo temporal. A pesar de su amplia difusión, la extensión y duración de estas pruebas dificultan su utilización dentro de baterías de evaluación del procesamiento auditivo. Sin embargo, dadas sus características estructurales, pareciera ser posible reducirlas sin perder su precisión diagnóstica. Objetivo: Determinar las propiedades diagnósticas de versiones abreviadas de las pruebas de patrones de frecuencia y patrones de duración. Material y Método: Se realizó un estudio transversal de diseño observacional analítico. Se evaluaron 166 oídos de 88 sujetos con edades entre 18 y 33 años, los cuales fueron clasificados con normalidad o alteración del ordenamiento auditivo temporal. Se utilizaron las pruebas originales de Auditec de 30 ítems por oído como referencia y los primeros 10 ítems de cada oído como versión abreviada. Resultados: La versión abreviada de la prueba de patrones de frecuencia obtuvo una sensibilidad de un 94,33%, una especificidad del 94,29% y un área bajo la curva ROC de 0,980. La versión abreviada de la prueba de patrones de duración obtuvo una sensibilidad de un 89,58%, especificidad del 71,88% y un área bajo la curva ROC de 0,916. Ambas versiones tuvieron un índice de concordancia adecuado. Conclusiones: Las versiones abreviadas de la prueba de patrones de frecuencia y patrones de duración cuentan con excelentes propiedades diagnósticas para la evaluación del ordenamiento auditivo temporal y pueden ser utilizadas de manera intercambiable con las versiones originales.

Introduction: The frequency and duration pattern tests are considered the gold standard for assessing auditory temporal ordering. Despite their wide dissemination, the length and duration of these tests make it difficult to use them within auditory processing assessment batteries. However, given their structural characteristics, reducing them without losing their diagnostic accuracy seems possible. Aim: Determine the diagnostic properties of abbreviated versions of the Frequency Patterns and Duration Patterns tests. Material and Method: A cross-sectional study with an analytical observational design was carried out. 166 ears of 88 subjects aged between 18 and 33 years were evaluated, classified as normal or altered in temporal auditory order. The original Auditec tests of 30 items per ear were used as a reference, and the first 10 items of each ear as an abbreviated version. Results: The abbreviated version of the frequency patterns test obtained a sensitivity of 94.33%, a specificity of 94.29%, and an area under the ROC curve of 0.980. The abbreviated version of the duration pattern test obtained a sensitivity of 89.58%, a specificity of 71.88%, and an area under the ROC curve of 0.916. Both versions had an adequate concordance index. Conclusion: The abbreviated versions of the frequency patterns and duration patterns test have excellent diagnostic properties for assessing auditory temporal ordering and can be used interchangeably with the original versions.

The use of the Feather Squadron to identify auditory processing disorders in South African children: a comparative study.

OBJECTIVE: Development of the Feather Squadron (FS) has created a cost-effective, accessible form of assessment through tele-audiology. As accessibility to reliable, cost-effective assessment of auditory processing (AP) skills is limited in South Africa (SA), this study aims to establish whether there is correlation between the FS and traditional tests of AP viz. Frequency Pattern and Dichotic Digits Test, and to establish its relevance to the SA population. DESIGN: Retrospective, within-subject, comparative design used to compare performance on the FS and the traditional tests. Data were considered in two ways: Firstly, using the traditional -2SD cut-off on some subtests of the FS compared to the same traditional tests, and secondly, by comparing the Z-scores obtained on the FS compared to Z-scores on the same traditional tests obtained by applying a double arcsine transformation. STUDY SAMPLE: Sixty-six subjects (35 males, 31 females) aged between 8.08 and 9.75 years (mean = 8.73; SD = 0.51) seen for AP assessments between 2016 and 2019. RESULTS: -2SD criteria yielded no significant association (p > 0.05). Z-score comparison suggested a statistically significant correlation (p < 0.05). CONCLUSION: A statistically significant correlation between certain subtests of FS with traditional tests of AP to merit its use in the SA population is suggested.

Subcortical and Cortical Electrophysiological Measures in Children With Speech-in-Noise Deficits Associated With Auditory Processing Disorders.

PURPOSE: The aim of this study was to analyze the subcortical and cortical auditory evoked potentials for speech stimuli in children with speech-in-noise (SIN) deficits associated with auditory processing disorder (APD) without any reading or language deficits. METHOD: The study included 20 children in the age range of 9-13 years. Ten children were recruited to the APD group; they had below-normal scores on the speech-perception-in-noise test and were diagnosed as having APD. The remaining 10 were typically developing (TD) children and were recruited to the TD group. Speech-evoked subcortical (brainstem) and cortical (auditory late latency) responses were recorded and compared across both groups. RESULTS: The results showed a statistically significant reduction in the amplitudes of the subcortical potentials (both for stimulus in quiet and in noise) and the magnitudes of the spectral components (fundamental frequency and the second formant) in children with SIN deficits in the APD group compared to the TD group. In addition, the APD group displayed enhanced amplitudes of the cortical potentials compared to the TD group. CONCLUSION: Children with SIN deficits associated with APD exhibited impaired coding/processing of the auditory information at the level of the brainstem and the auditory cortex. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21357735.

Visual Processing Impairment in Children With Suspected Auditory Processing Disorder: A Transdisciplinary Dimensional Approach to Diagnosis.

PURPOSE: The purpose of this study is to explore the utility of impairment(s) in language (LI), manual dexterity (IMD), and visual perceptual skills (IVPS) as a reference standard for diagnosing auditory processing disorder (APD). METHOD: Data from 104 participants with suspected APD (males = 57, females = 47; 6-16 years) were retrospectively analyzed. Index auditory processing (AP) tests included Auditory Figure Ground 0 dB, Competing Words-Directed Ear (CW-DE), and Time-Compressed Sentences (TCS). General Communication Composite (GCC) of the Children's Communication Checklist-2, manual dexterity (MD) component of the Movement Assessment Battery for Children-Second Edition, and Test for Visual Perceptual Skills-Third Edition (TVPS-3) were used to identify LI, IMD, and IVPS, respectively. RESULTS: Eighty-one (77.8%), 58 (55.8%), and 37 (35.6%) participants had LI, IVPS, and IMD, respectively. Four factors explaining 67.69% of the variance were extracted. TVPS-3 (except visual closure [VClo]) represented the first; AFG 0, VClo, and MD the second; CW-DE and GCC the third; and TCS the fourth. APD diagnosed by combining AP tests and comorbidities had better accuracy compared to AP tests alone. The combined approach had overall diagnostic accuracy of 92.2%, 88.4%, and 81.7% for the 9th, 5th, and 2nd percentile AP test cutoffs, respectively. CONCLUSIONS: First-order AP tests in this study were related to language, MD, and visual perceptual skills. Given the overlap of LI, IMD, and IVPS with impaired AP, these comorbidities are an effective reference standard for APD. APD can be diagnosed following failing one AP test if one or more comorbidities exist. Ninth percentile AP test cutoff had better diagnostic accuracy compared to the currently used 2nd percentile cutoff.

The Auditory Processing Domains Questionnaire (APDQ): Brazilian-Portuguese version.

OBJECTIVE: The present study aimed to determine the fidelity, reliability, and internal validity of the APDQ when translated from English to Brazilian-Portuguese language. METHODS: The first phase included the APDQ translation into Brazilian-Portuguese including forward translation, translation assessment and back-translation in a group of 10 students. The second phase involved establishing the internal consistency and reliability of the APDQ Brazilian-Portuguese version. Data was collected from 66 students without any risk factor for auditory processing disorder. Subjects were divided into a younger group (7-10 yrs) and an older group (11-17 yrs). RESULTS: All items showed appropriate quality in terms of translation. In determining internal consistency, Cronbach's alpha in subscales of auditory processing, attention and language was found to be 0.93, 0.85 and 0.74, respectively. Intraclass Correlation Coefficient for total score was 0.95, ensuring a strong test-retest reliability. CONCLUSION: The Brazilian-Portuguese version of the APDQ has favorable translation quality, internal validity and reliability. It is now ready for continued study as a differential screening tool for 7- to 17-year-old Brazilian children with listening difficulties who are at risk for auditory processing disorder, attention deficits and language learning challenges.