Nickisch A, Kiese-Himmel C
1Leiter Pädaudiologie-Phoniatrie-Logopädie, Kliniken des Bezirks Oberbayern, Kommunalunternehmen, Kinderzentrum München, München.
Laryngorhinootologie. 2009 Jul;88(7):469-76. doi: 10.1055/s-0028-1119403. Epub 2009 Feb 23.
Eclectic test combinations are usually applied for diagnosing (Central) Auditory Processing Disorders (C)APD in school-aged children.
Children with suspected APD were examined with a combination of 12 audiological and psychometric tests in order to allow the proper allocation to either the APD-group or to the Non-APD-group.
Forty-six 8-10-year-old children diagnosed with auditory-specific perceptual deficits [clinical group (C)APD; average age 9;2 years; SD 0;7 years] were compared to 39 normally developed children of the same age span with no evidence of specific language impairment, developmental dyslexia or learning disorders [control group Non-APD; average age 9;3 years; SD 0;7 years].
Overall, the Non-APD-group scored significantly better than the (C)APD-group with the exception of three non-verbal auditory tests. The clinical group and the control group were successfully differentiated: 94% and (after cross-validation) 91% of the children respectively could be diagnosed correctly by using only three tests (significant discriminant function). Of these, Mottier's Test (nonword repetition) showed the highest discriminatory power followed by speech in noise discrimination and "phoneme differentiation" of the Heidelberger Phoneme Discrimination Test.
After the differential diagnostic exclusion of peripheral hearing disorders and cognitive impairments, these three tests are sufficient to initially justify the clinical-diagnostic classification "(C)APD" in 8-11-year-old children taking into account only a relatively slight probability of error. Poor results in two of the three differentiating tests (discrepancy criterion of >1 SD of the reference population) are sufficient to support the diagnostic classification of an (C)APD.
综合测试组合通常用于诊断学龄儿童的(中枢)听觉处理障碍(C)APD。
对疑似APD的儿童进行了12项听力学和心理测量测试的组合检查,以便正确分配到APD组或非APD组。
将46名8至10岁被诊断为听觉特异性感知缺陷的儿童[临床组(C)APD;平均年龄9岁2个月;标准差0岁7个月]与39名同年龄范围的正常发育儿童进行比较,这些儿童没有特定语言障碍、发育性阅读障碍或学习障碍的证据[对照组非APD;平均年龄9岁3个月;标准差0岁7个月]。
总体而言,除了三项非语言听觉测试外,非APD组的得分明显高于(C)APD组。临床组和对照组成功区分:仅使用三项测试(显著判别函数),分别有94%和(交叉验证后)91%的儿童能够被正确诊断。其中,莫蒂埃测试(非单词重复)显示出最高的判别力,其次是噪声中的语音辨别和海德堡音素辨别测试的“音素区分”。
在排除外周听力障碍和认知障碍的鉴别诊断后,这三项测试足以初步证明在8至11岁儿童中进行“(C)APD”临床诊断分类是合理的,同时仅考虑相对较小的错误概率。三项鉴别测试中有两项结果不佳(参考人群标准差>1的差异标准)足以支持(C)APD的诊断分类。