Kiese-Himmel C, Kruse E
Abteilung Phiniatrie/Pädaudiologie, Georg-August-Universität Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen.
Laryngorhinootologie. 2006 Oct;85(10):738-45. doi: 10.1055/s-2006-925325.
APDs at infancy has become a common reason of introduction at phoniatric/pedaudiologic departments. The question arises whether this neurocognitive construct can be accounted with the standard clinical diagnostics.
The children with suspicion of APD referred to the Department of Phoniatrics/Pedaudiology at the University Hospital Goettingen/Germany were clinically examined.
Of 107 children 8 % demonstrated abnormal hearing acuity, 7 % learning and intelligence disorders, 7 % developmental dyslexia, 6 % language impairments, and 5 % attention deficit/hyperactivity. So, 59 children remained for evaluating for an APD (mean age: 85.3; SD 16.3 months).
Their auditory performances were normdeviant from 7 % (speech audiometry) to 86 % (auditory sequential short-term memory for non-words). 55 % of the children exhibited a reduced dichotic word discrimination, 59 % a performance below norm level in auditory sequential memory for digits, and 86 % for non-words. Next step, the children of the study group were distributed according to their therapy situations at the time of examination: without; speech therapy; occupational therapy; speech therapy + occupational therapy. No significant group effects were found in the mean performances of the audiometric and psychometric tests, even though the results considerably differed. No auditory dimension made a contribution to separate the groups in a stepwise discriminant analysis.
There was a notably inherent heterogeneity of the population presenting with auditory processing problems. The overall objective of the APD evaluation must be to assess processing skills apart from complex stimuli like language skills (e. g. parameter of tones, memory of tone pitch).
婴儿期听觉处理障碍已成为儿童听力/小儿听力学科室常见的就诊原因。问题在于这种神经认知结构能否通过标准临床诊断来解释。
对德国哥廷根大学医院儿童听力/小儿听力学科室疑似患有听觉处理障碍的儿童进行临床检查。
107名儿童中,8%表现出听力敏锐度异常,7%存在学习和智力障碍,7%有发育性阅读障碍,6%有语言障碍,5%有注意力缺陷/多动障碍。因此,59名儿童留待评估是否患有听觉处理障碍(平均年龄:85.3个月;标准差16.3个月)。
他们的听觉表现偏离正常范围,从7%(言语测听)到86%(非词听觉序列短期记忆)不等。55%的儿童表现出双耳分听单词辨别能力下降,59%在数字听觉序列记忆方面表现低于正常水平,86%在非词听觉序列记忆方面表现低于正常水平。下一步,根据研究组儿童在检查时的治疗情况进行分组:未接受治疗;言语治疗;职业治疗;言语治疗+职业治疗。尽管结果差异很大,但在听力测试和心理测试的平均表现中未发现显著的组间效应。在逐步判别分析中,没有任何听觉维度有助于区分这些组。
存在听觉处理问题的人群存在显著的内在异质性。听觉处理障碍评估的总体目标必须是评估除语言技能等复杂刺激之外的处理技能(例如音调参数、音高记忆)。