McDermott Erin E, Smart Jennifer L, Boiano Julie A, Bragg Lisa E, Colon Tiffany N, Hanson Elizabeth M, Emanuel Diana C, Kelly Andrea S
Towson University, Towson, MD.
Ascent Audiology & Hearing, McLean, VA.
J Am Acad Audiol. 2016 Feb;27(2):72-84. doi: 10.3766/jaaa.14050.
Large discrepancies exist in the literature regarding definition, diagnostic criteria, and appropriate assessment for auditory processing disorder (APD). Therefore, a battery of tests with normative data is needed.
The purpose of this study is to collect normative data on a variety of tests for APD on children aged 7-12 yr, and to examine effects of outside factors on test performance.
Children aged 7-12 yr with normal hearing, speech and language abilities, cognition, and attention were recruited for participation in this normative data collection.
One hundred and forty-seven children were recruited using flyers and word of mouth. Of the participants recruited, 137 children qualified for the study. Participants attended schools located in areas that varied in terms of socioeconomic status, and resided in six different states.
Audiological testing included a hearing screening (15 dB HL from 250 to 8000 Hz), word recognition testing, tympanometry, ipsilateral and contralateral reflexes, and transient-evoked otoacoustic emissions. The language, nonverbal IQ, phonological processing, and attention skills of each participant were screened using the Clinical Evaluation of Language Fundamentals-4 Screener, Test of Nonverbal Intelligence, Comprehensive Test of Phonological Processing, and Integrated Visual and Auditory-Continuous Performance Test, respectively. The behavioral APD battery included the following tests: Dichotic Digits Test, Frequency Pattern Test, Duration Pattern Test, Random Gap Detection Test, Compressed and Reverberated Words Test, Auditory Figure Ground (signal-to-noise ratio of +8 and +0), and Listening in Spatialized Noise-Sentences Test. Mean scores and standard deviations of each test were calculated, and analysis of variance tests were used to determine effects of factors such as gender, handedness, and birth history on each test.
Normative data tables for the test battery were created for the following age groups: 7- and 8-yr-olds (n = 49), 9- and 10-yr-olds (n = 40), and 11- and 12-yr-olds (n = 48). No significant effects were seen for gender or handedness on any of the measures.
The data collected in this study are appropriate for use in clinical diagnosis of APD. Use of a low-linguistically loaded core battery with the addition of more language-based tests, when language abilities are known, can provide a well-rounded picture of a child's auditory processing abilities. Screening for language, phonological processing, attention, and cognitive level can provide more information regarding a diagnosis of APD, determine appropriateness of the test battery for the individual child, and may assist with making recommendations or referrals. It is important to use a multidisciplinary approach in the diagnosis and treatment of APD due to the high likelihood of comorbidity with other language, learning, or attention deficits. Although children with other diagnoses may be tested for APD, it is important to establish previously made diagnoses before testing to aid in appropriate test selection and recommendations.
关于听觉处理障碍(APD)的定义、诊断标准及恰当评估,文献中存在巨大差异。因此,需要一套具备标准化数据的测试。
本研究旨在收集7至12岁儿童APD各项测试的标准化数据,并考察外部因素对测试表现的影响。
招募听力、言语和语言能力、认知及注意力正常的7至12岁儿童参与此项标准化数据收集。
通过传单和口碑招募了147名儿童。招募的参与者中,137名儿童符合研究要求。参与者就读于社会经济地位各异地区的学校,并居住在六个不同州。
听力学测试包括听力筛查(250至8000赫兹,15分贝听力级)、单词识别测试、鼓室图、同侧和对侧反射以及瞬态诱发耳声发射。分别使用语言基本能力临床评估量表-4筛查版、非言语智力测试、语音处理综合测试以及视觉听觉整合持续性操作测试,对每位参与者的语言、非言语智商、语音处理及注意力技能进行筛查。行为APD测试组合包括以下测试:双耳数字测试、频率模式测试、时长模式测试、随机间隙检测测试、压缩和混响单词测试、听觉场景分析(信噪比为+8和+0)以及空间噪声中的句子聆听测试。计算每项测试的平均分和标准差,并使用方差分析来确定性别、利手和出生史等因素对每项测试的影响。
为以下年龄组创建了测试组合的标准化数据表:7至8岁组(n = 49)、9至10岁组(n = 40)以及11至12岁组(n = 48)。未发现性别或利手对任何测量指标有显著影响。
本研究收集的数据适用于APD的临床诊断。当已知语言能力时,使用语言负荷较低的核心测试组合并增加更多基于语言的测试,能够全面了解儿童的听觉处理能力。对语言、语音处理、注意力和认知水平进行筛查,可以提供更多关于APD诊断的信息,确定测试组合对个体儿童的适用性,并可能有助于提出建议或进行转诊。由于APD与其他语言、学习或注意力缺陷共病的可能性很高,因此在APD的诊断和治疗中采用多学科方法很重要。虽然患有其他诊断的儿童可能会接受APD测试,但在测试前确定先前做出的诊断很重要,这有助于进行适当的测试选择和提出建议。