Weihing Jeffrey, Guenette Linda, Chermak Gail, Brown Mallory, Ceruti Julianne, Fitzgerald Krista, Geissler Kristin, Gonzalez Jennifer, Brenneman Lauren, Musiek Frank
Division of Communicative Disorders, University of Louisville, Louisville, KY.
Department of Speech, Language, and Hearing Sciences, University of Connecticut, Storrs, CT.
J Am Acad Audiol. 2015 Jul-Aug;26(7):652-69. doi: 10.3766/jaaa.14108.
Although central auditory processing disorder (CAPD) test battery performance has been examined in adults with neurologic lesions of the central auditory nervous system (CANS), similar data on children being referred for CAPD evaluations are sparse.
This study characterizes CAPD test battery performance in children using tests commonly administered to diagnose the disorder. Specifically, this study describes failure rates for various test combinations, relationships between CAPD tests used in the battery, and the influence of cognitive function on CAPD test performance and CAPD diagnosis. A comparison is also made between the performance of children with CAPD and data from patients with neurologic lesions of the CANS.
A retrospective study.
Fifty-six pediatric patients were referred for CAPD testing.
Participants were administered four CAPD tests, including frequency patterns (FP), low-pass filtered speech (LPFS), dichotic digits (DD), and competing sentences (CS). In addition, they were given the Wechsler Intelligence Scale for Children (WISC). Descriptive analyses examined the failure rates of various test combinations, as well as how often children with CAPD failed certain combinations when compared with adults with CANS lesions. A principal components analysis was performed to examine interrelationships between tests. Correlations and regressions were conducted to determine the relationship between CAPD test performance and the WISC.
Results showed that the FP and LPFS tests were most commonly failed by children with CAPD. Two-test combinations that included one or both of these two tests and excluded DD tended to be failed more often. Including the DD and CS test in a battery benefited specificity. Tests thought to measure interhemispheric transfer tended to be correlated. Compared with adult patients with neurologic lesions, children with CAPD tended to fail LPFS more frequently and DD less frequently. Both groups failed FP with relatively equal frequency.
The two-test combination that showed the highest failure rate for children with CAPD was LPFS-FP. Comparison with adults with CANS lesions, however, suggests that the mechanisms underlying LPFS performance in children need to be better understood. The two-test combination that showed the next highest failure rates among children with CAPD and did not include LPFS was CS-FP. If it is desirable to use a dichotic measure that has a lower linguistic load than CS then DD can be substituted for CS despite the slightly lower failure rate of the DD-FP battery.
虽然已对患有中枢听觉神经系统(CANS)神经病变的成年人进行了中枢听觉处理障碍(CAPD)测试组的性能检测,但关于被转诊进行CAPD评估的儿童的类似数据却很稀少。
本研究使用常用于诊断该障碍的测试来描述儿童CAPD测试组的性能。具体而言,本研究描述了各种测试组合的失败率、测试组中使用的CAPD测试之间的关系,以及认知功能对CAPD测试性能和CAPD诊断的影响。还对患有CAPD的儿童的表现与CANS神经病变患者的数据进行了比较。
一项回顾性研究。
56名儿科患者被转诊进行CAPD测试。
对参与者进行了四项CAPD测试,包括频率模式(FP)、低通滤波言语(LPFS)、双耳数字(DD)和竞争性句子(CS)。此外,还对他们进行了韦氏儿童智力量表(WISC)测试。描述性分析检查了各种测试组合的失败率,以及与患有CANS病变的成年人相比,患有CAPD的儿童对某些组合测试失败的频率。进行了主成分分析以检查测试之间的相互关系。进行了相关性和回归分析以确定CAPD测试性能与WISC之间的关系。
结果表明,患有CAPD的儿童最常无法通过FP和LPFS测试。包含这两项测试中的一项或两项且排除DD的两项测试组合往往更容易失败。在测试组中纳入DD和CS测试有利于提高特异性。被认为用于测量半球间传递的测试往往具有相关性。与患有神经病变的成年患者相比,患有CAPD的儿童更频繁地无法通过LPFS测试,而较少无法通过DD测试。两组在FP测试上的失败频率相对相当。
对于患有CAPD的儿童,失败率最高的两项测试组合是LPFS-FP。然而,与患有CANS病变的成年人相比,这表明需要更好地理解儿童LPFS测试表现背后的机制。在患有CAPD的儿童中失败率次之且不包括LPFS的两项测试组合是CS-FP。如果希望使用语言负荷低于CS的双耳测试方法,那么尽管DD-FP测试组的失败率略低,也可以用DD替代CS。