Evaluation and Treatment of Central Auditory Processing and Sound Tolerance Disorders

Abstract 1 Introduction: Central auditory processing disorder (CAPD) affects how a listener understands speech even though their peripheral auditory system is intact. Case Presentation: An adult female was seen for a CAPD evaluation after experiencing recent listening difficulties following an automobile accident while 20 weeks pregnant. Results from a comprehensive audiological evaluation revealed audiometrically normal hearing in both ears. Results from the CAPD evaluation suggested a prosodic deficit. Discussion: Although results from testing were consistent with a prosodic deficit, the patient’s case history, original complaints, and recommendations were more consistent with an integration deficit. Conclusion: This case demonstrates that clinicians should thoroughly examine a patient’s clinical history. For this case, recommendations aligned with an integration deficit, as opposed to a prosodic processing disorder. Abstract 2 Introduction: A sound tolerance disorder is when individuals have adverse (either physical or emotional) responses to everyday sounds. A sound tolerance disorder is a broad term that encompasses tinnitus, hyperacusis, misophonia, and phonophobia. Case Presentation: A young adult female was seen for a sound tolerance evaluation. Results from an audiological evaluation revealed normal hearing thresholds and results from a sound tolerance evaluation indicated that a majority of responses to uncomfortable listening levels were in the normal range, which is consistent with hyperacusis. Discussion: Due to reduced uncomfortable listening levels, the patient was diagnosed with hyperacusis and misophonia, and extensive counseling was conducted. The counselor explained what hyperacusis was and presented the various treatment options available to the patient, including sound therapy and cognitive behavioral therapy. Conclusion: This case demonstrates that there may be multiple options available to aid in successful treatment for the patient, while some options may require collaboration with mental health professionals

The effect of auditory processing abilities on acceptable noise levels

The purpose of the present study was to determine typical acceptable noise levels (ANLs) in children diagnosed with auditory processing disorder (APD) and compare those to ANLs in children without APD. Sixteen participants, eight children with APD and eight children without APD, were administered a complete audiological evaluation and a series of APD tests [Filtered Words, Competing Sentences, and Auditory Figure Ground (0) subtests of the SCAN– 3C; Staggered Spondaic Word test; and Pitch Pattern test] to determine normal or abnormal auditory processing ability. Conventional ANLs were measured on each participant to determine acceptance of background noise. The results revealed no significant difference for ANLs in participants with and without APD; however, a trend for lower ANLs in those without APD seemed to be presented. Furthermore, the results showed no significant correlation between ANL and any administered APD test. Possible clinical implications/applications were discussed

Evaluating Auditory Processing in Adolescents and Adults Following a Sports-Related Concussion

Sports-related concussions (SRCs) have gained increasing attention in recent years due to the long-lasting effects. While concussions have been extensively studied, the impact on auditory processing in adolescents and adults remains an under-evaluated area within audiology. This gap in research is noteworthy as audiologists are well-positioned to conduct auditory processing disorder (APD) testing, and post-concussion auditory deficits fall within the scope of their practice. This study addresses the lack of consensus on concussion definitions, limited accurate prevalence data, and the absence of guidelines for assessing auditory processing in post-concussion individuals in the audiology field. The research aims to provide a framework for evaluating auditory processing in adults with a history of sports-related concussions. The research findings reveal a compelling link between concussions and APD, with individuals who have experienced multiple concussions exhibiting significant deficits, particularly in listening in noisy environments. The overlap of symptoms experienced following a concussion and those associated with APD (e.g., inattentiveness, difficulty pulling valuable information out of background noise, and a lack of auditory memory) and the overlap of affected anatomical structures such as the corpus callosum, midbrain, and temporal lobe indicate the need for audiological involvement. These connections between concussions and auditory processing difficulties underscore the importance of considering auditory processing assessments in the broader context of post-concussion care alongside a multidisciplinary team. By highlighting the relationship between concussions and APD, this research aims to contribute valuable insights to the field of audiology. The conclusions provide a foundation for the development of standardized clinical guidelines by professional organizations, facilitating more effective evaluation and treatment of post-concussive auditory processing deficits. This research addresses a critical gap in the field, emphasizing the vital role of audiologists in comprehensive care for post-concussion individuals

Constructing and Norming Arabic Screening Tool of Auditory Processing Disorders: Evaluation in a Group of Children at Risk for Learning Disability

The purposes of this study were to develop and provide the normative data of Arabic screening tool for screening the children with auditory processing disorders: an Arabic version of Adaptive Auditory Speech Test (AAST) in quiet for screening the peripheral hearing in dB SPL units; an Arabic AAST in binaural noise for screening the temporal interaction deficit: listening speech in binaural noise in dB SNR units, then teetaatoo test with a five subtests for screening the Modern Standard Arabic language phonemes identification ability. Participants included 338 children aged from 5 to 7 years old (138 males, 200 females; mean age = 6.08 years with standard deviation = 0.8) from a regular nursery school which called Baroot Summer Club in Beni-Suef in Egypt were recruited to participate in the study. According to the calculated Norms of AAST in quiet and through a meeting with the teachers of children in the nursery school, 129 children were sift out with no hearing loss, negative histories of neurological disorders, head trauma or surgery, dizziness, and attention deficit disorder/attention deficit hyperactivity disorder. 129 children were screened for listening in binaural noise using the Arabic AAST in binaural noise, then the left 94 children, because 35 children couldn`t complete the testing, was screened for phonemes identification ability using teetaatoo test(the five sub tests). For the AAST in quiet, 21 to 33 dB SPL is the normal range of the hearing peripheral loss, especially, for the AAST in binaural noise, there are three different norms; -9 to -13 dB SNR is the normal range of children aged 5 years old, -10 to -13 dB SNR is the normal range of children aged 6 years old, and -10 to -14 dB SNR is the normal range of children aged 7 years old. Finally, for the five subtests (teetaatoo): > 85% (correct answers) is the normal percentage of the Cons-A, >62& (correct answers) is the normal percentage of the Cons-B1, >76% is the normal percentage of the Cons-B2, >63% (correct answers) is the normal percentage of the Cons-B3, and 84% (correct answers) is the normal percentage of the Vow-A. Further, according to the previous norms, 23 children represent 17,8% from the whole sample (N=129) with a normal speech recognition threshold have scored abnormally on the speech listening in bin-noise (AAST in bin-noise) or on at least one subtest from teetaatoo subtests and were considered at risk for learning disability because of their scores on a SIFTER

Efficacy of central auditory processing case history form used at the Louisiana Tech University Speech and Hearing Center

Central auditory processing disorder (CAPD) is a deficiency in processing of auditory information. Due to this deficiency, a variety of behaviors can be seen including listening difficulties in background noise, difficulties following oral instruction, and difficulties discriminating and identifying speech sounds. These behaviors result in inattention and academic difficulties. With these characteristics being present in other disorders such as attention deficit/hyperactivity disorder, language/learning deficits, and high functioning autism (i.e., Asperger\u27s syndrome) diagnosis of CAPD becomes complicated. The Louisiana Tech University Speech and Hearing Center uses a CAPD case history for a child that was adopted from Robert Keith in 2003. The purpose of this paper is to determine the efficacy of the subsections (e.g., general history, statement of the problem, birth and developmental information, medical history, personality traits and physical characteristics) through literature based research. Assuming that some items listed on the current CAPD case history are not supported by literature, a proposed new CAPD case history form for children will be developed based on information found

Three studies on the assessment and diagnosis of auditory processing disorders

Three studies on the assessment and diagnosis of Auditory Processing Disorder (APD) were conducted. The first study measured the failure rate of AP tests (speech and non-speech) and the APD diagnosis rate using four different diagnostic criteria. A retrospective analysis was conducted on test scores of 117 individuals with suspected APD. Failure rate was 3 to 4 times higher on the speech tests than the non-speech tests and consequently, there was a decrease in the diagnosis rate of APD when non-speech tests were included. Based on these findings, it was recommended that test batteries used to diagnose APD should include at least one non-speech test. The second study questioned whether an adding 2 seconds to the response time in three AP tests would benefit both typically developing students and those with learning disabilities. Learning disabled (LD) and 12 typically developing (TD) children (24 and 12 children, respectively) were administered three AP tests, Dichotic Digits (DD), Duration Pattern Sequence (DPS), and Random Gap Detection (RGD), under standard and extended time conditions. Students with LD improved significantly on the DD and DPS tests in the extended time condition. These findings indicate that adding 2 seconds to response time will significantly reduce the rate of APD diagnosis in students with LD. The third study investigated whether children with suspected APD are normally distributed between 1 and 2 standard deviations (SDs) below the mean. Retrospective analysis of AP assessments of 98 children did in fact show a normal distribution. Analysis revealed that the measured difference in the sample was not significantly different from the expected difference of 13.59% between 1 and 2SD. Consistent with AAA and ASHA guidelines, performance below 2 SD on at least two tests should be used to diagnose APD

Behavioral and electrophysiological assessment of children with a specific temporal processing disorder

Auditory processing disorders (APDs) have received considerable attention over the past few decades. Much of the attention has focused on the controversy surrounding the operational definition of APD, the heterogeneous nature of APD, and an appropriate test battery for APD assessment. Temporal processing deficits are one characteristic of APD and are the focus of the present investigation. This investigation reports behavioral and early electrophysiological measures in a group of children with specific temporal processing difficulties and an age-matched control group. In an effort to better describe the subjects, two language tests and the SCAN-C were administered. Significant differences were found in the language tests, SCAN-C, and behavioral tests of temporal processing. No significant differences in ABR waveform latency were found between the control and experimental group. Significant amplitude differences were found, albeit small. Binaural interaction was present in both groups. Based on the results of the present well-controlled investigation of children with temporal processing disorders, there is no indication that the auditory brainstem response recording to click stimuli is efficient in providing additional diagnosis of APD

The central auditory processing and continuous performance of children with Attention Deficit Hyperactivity Disorder (ADHD) in the medicated and non-medicated state

Please read the abstract in the section 00front of this documentThesis (DPhil (Communication Pathology))--University of Pretoria, 2006.Speech-Language Pathology and AudiologyDPhilUnrestricte

Dichotic Listening Test Performance In Children

Dichotic tests evaluate binaural integration through simultaneous presentation of different stimuli to each ear of a listener who has normal hearing sensitivity in both ears. Dichotic listening deficits may lead to problems with language, communication, reading, or academic performance. If accurately identified, dichotic deficits may be treatable with listening training or managed with accommodation. However, it is not clear which of several commercially-available dichotic test recordings are best for audiologists to use when assessing binaural integration in children. Literature review revealed limited evidence of reliability, accuracy, usefulness, or value for dichotic tests applied to children. Of 11 dichotic tests identified, five reported some evidence of test-retest reliability. Correlation between results on repeated administration was moderate to good (r=0.59 to 0.92). Evidence of accuracy was identified for 5 tests but was not generalizable due to significant limitations in study design. No evidence was found to either support or dispute claims of usefulness or value. Since reliability is a necessary prerequisite for good test performance, we sought to directly compare test-retest reliability for three dichotic measures: SCAN-3 Competing Words (CW), Musiek\u27s Double Dichotic Digits (DD-M), and Bergen Dichotic Listening Test with Consonant-Vowel Syllables (CV-B). Sixty English-speaking children, 7-14 years old with normal hearing, had a single study-visit during which each test was administered twice. Changes on retest were compared to binomial model predictions, summarized by within-subject standard deviation (Sw), and compared among tests. Correlates of variance were explored. All 3 tests had reliability within bounds predicted by binomial model. Forty-item scores were more reliable (Sw=5%) than those based on 20-30 items (Sw=6-8%). No associations between participant characteristics and reliability were found. CW and DD-M were evaluated for evidence of agreement and decision consistency. Although participants were rank ordered similarly by right ear (ρ = 0.58), left ear (ρ = 0.51) and total (ρ = 0.73) scores, the tests did not agree on ranking by inter-aural asymmetry (ρ =0.18). CW and DD-M did not agree on direction of ear advantage (κ = 0.01, p = 0.93) and had poor agreement on which children displayed dichotic deficits (κ = 0.22, p \u3c 0.01). DD identified significantly more participants with deficits (n=18) than CW (n=3) (p \u3c 0.001). Although dichotic procedures show moderate reliability, their precision is limited. Assessment of their accuracy is limited by the absence of a widely-accepted gold standard reference test, but two commonly used tests failed to agree on which children had deficits. The data do not yet support routine clinical use of dichotic tests of binaural integration with children. Additional research is needed to determine if there are any conditions under which dichotic procedures demonstrate usefulness or value