Kiese-Himmel C, Reeh M
Phoniatrisch/Pädaudiologische Psychologie an der Abt. Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Göttingen, Waldweg 37, 37073, Göttingen, Deutschland.
HNO. 2009 Dec;57(12):1285-90. doi: 10.1007/s00106-009-1911-6.
It is a controversial issue whether sequential processing in children with auditory processing disorders (APD) is a unimodal auditory impairment.
Normal achieving controls (n=12; mean age: 101.1 months; SD 20.3) and children referred to clinical facilities for assessment including children with monosymptomatic APD (n=25; mean age: 90.8 months; SD 9.8), children with developmental language disorder (DLD]) + APD (n=11; mean age: 89.5 months; SD 14.9), children with dyslexia + APD (n=10; mean age: 113.8 months; SD 17.1) were compared using the subtest digit recall of the German version of the K-ABC (Melchers & Preuss 2001) and the K-ABC subtest hand movements in the visual modality.
On average all groups tended to perform alike in visual sequential processing and memory (T-score>50). Normal controls (non-APD) showed on average the best test performance (T-score 57.4; SD 10.5), but the mean performance did not differ significantly from children with APD. All groups also presented on average normal test performance in the auditory modality however, children of the clinical groups were below the age mean (DLD + APD: T-W 43.1; SD 6.8; monosymptomatic APD: T-W 45.8; SD 9.8; dyslexia + APD: 46.7; SD5.8). Children with DLD + APD and those with monosymptomatic APD exhibited a significantly lower but not poor performance in auditory processing of sequences compared to their performance in visual sequential processing. The results of auditory and visual processing of sequences were significantly correlated in the clinical groups DLD + APD (0.58) and monosymptomatic APD (0.34), but not in the smallest group dyslexia + APD (0.48) and in normal achieving controls (0.32).
On the basis of the results of the present study it may be concluded that a normal test performance on visual measure does not exclude a bimodal or pansensory seriation disorder in children with APD. It does, however, indicate the existence of a primary auditory sequential processing deficit, because at least the processing of phonological and visual stimuli was not separately carried out in children with DLD + APD.
听觉处理障碍(APD)儿童的序列处理是否为单峰听觉损伤是一个有争议的问题。
使用德文版考夫曼儿童评估成套测验(K-ABC)(梅尔彻斯和普吕斯,2001年)的数字回忆子测验以及视觉模式下的K-ABC手部动作子测验,对正常发育儿童(n = 12;平均年龄:101.1个月;标准差20.3)和转介至临床机构进行评估的儿童进行比较,这些儿童包括单症状APD儿童(n = 25;平均年龄:90.8个月;标准差9.8)、发育性语言障碍(DLD)+ APD儿童(n = 11;平均年龄:89.5个月;标准差14.9)、阅读障碍+ APD儿童(n = 10;平均年龄:113.8个月;标准差17.1)。
平均而言,所有组在视觉序列处理和记忆方面的表现趋于相似(T分数>50)。正常对照组(非APD)平均表现出最佳测试成绩(T分数57.4;标准差10.5),但其平均成绩与APD儿童无显著差异。所有组在听觉模式下的测试成绩平均也正常,然而,临床组儿童的成绩低于年龄均值(DLD + APD:T分数43.1;标准差6.8;单症状APD:T分数45.8;标准差9.8;阅读障碍+ APD:46.7;标准差5.8)。与视觉序列处理表现相比,DLD + APD儿童和单症状APD儿童在序列听觉处理方面表现显著较低但并非不佳。在临床组DLD + APD(0.58)和单症状APD(0.34)中,序列听觉和视觉处理结果显著相关,但在最小的组阅读障碍+ APD(0.48)和正常发育儿童组(0.32)中不相关。
根据本研究结果可以得出结论,视觉测量测试成绩正常并不能排除APD儿童存在双峰或全感觉序列化障碍。然而,这确实表明存在原发性听觉序列处理缺陷,因为至少在DLD + APD儿童中,语音和视觉刺激的处理没有分别进行。