auditory processing disorder in children

It is clear from the diversity of terms just described that many researchers have, in part independently, come to the view that deficits in auditory perception can occur despite the presence of normal-hearing thresholds. We will use the term APD, for the reason outlined in the next section. With the exception of terms that imply a specific site of lesion or mechanism (e.g., cochlear synaptopathy), any term that is widely accepted, and understood in the same way, within and across relevant professions and by parents, should suffice. Hidden hearing loss is also sometimes used as a generic synonym for the 14 terms listed in the previous paragraph. These three terms describe very specific types of problems in the auditory system, but some researchers have suggested that these problems might be among the causes of the reduced auditory performance that gave rise to all the earlier terms.

1996), “Hidden hearing loss” ( Schaette & McAlpine 2011), and Cochlear synaptopathy ( Kujawa & Liberman 2009) have been used. More recently than these terms, the terms Auditory neuropathy spectrum disorder ( Starr et al. 1992), and Idiopathic discrimination dysfunction ( Rappaport et al. 1990), King-Kopetzky syndrome ( Hinchcliffe 1992), Auditory dysacusis ( Jayaram et al. These include Central auditory disorder and Disturbances of auditory perception ( Myklebust 1954), Central auditory dysfunction ( Berry & Blair 1976), Auditory inferiority complex ( Byrne & Kerr 1987), Selective dysacusis ( Narula & Mason 1988), Auditory disability with normal hearing ( Rendell & Stephens 1988), Obscure auditory dysfunction ( Saunders & Haggard 1989), Central presbyacusis ( Stach et al. These three terms are, however, minor variations on a theme compared with the diversity of terms that have been used to describe people who have abnormally poor auditory perception (usually of speech) despite having normal or near–normal-hearing thresholds. A position statement 5 years later determined that Central was still a useful component because “most definitions of the disorder focus on the central auditory nervous system,” and recommended the term (Central) APD ( ASLHA 2005). A consensus conference in 2000 determined that the word Central made the term too limited, because the cochlea also performs auditory processing ( Jerger & Musiek 2000). The term central auditory processing disorder (CAPD) has been used since at least 1976 ( Sullivan 1976). The article concludes with a summary of the research that must be conducted before the structured tests can be used to quantify the extent to which different potential causes of listening difficulties are responsible for real-life difficulties in an individual child. Attention displayed during the test is estimated from the fluctuations in performance during the test. As a further novel contribution, the impact of memory and attention on each test score is quantitatively allowed for, by an amount that depends on each test’s dependence on memory and attention. Subtraction of the deficits revealed by each test enables the contributions of each processing stage to a listening deficit to be quantified. For two of the stages, a listener’s performance is quantified as the additional signal to noise ratio that he or she needs to function equivalently to his or her age peers. In a fresh approach to the construction of test batteries, the stages of the model are linked to tests designed to assess either all or selected parts of the processes involved. This article uses a plausible, and hopefully noncontroversial, model of speech understanding that comprises auditory processing, speech processing, and language processing, all potentially affected by the degree of attention applied and the listener’s memory ability. Other possible causes are hearing deficits, cognitive deficits, and language deficits. This article suggests that the field use the term “listening difficulty” as an umbrella term to indicate a reported deficit in recognizing sounds or understanding speech, one possible cause of which is an auditory processing disorder.

That view has likely emerged because there has not been sufficient rigor in determining when difficulty in understanding speech has been the consequence of some type of auditory processing deficit, versus when it is the consequence of a cognitive deficit or a language deficit.

More substantively, even its existence has been questioned. Some of the controversy concerns what it is called. Auditory processing disorder, defined here as a deficit in the way sounds are analyzed by the brain, has remained a controversial topic within audiology for decades.

Auditory processing disorder in children