Wilson Wayne J
a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.
Int J Audiol. 2018 Apr;57(4):240-248. doi: 10.1080/14992027.2017.1409438. Epub 2018 Feb 1.
To consider the evolving concept of auditory processing disorder (APD).
Narrative review and opinion piece.
Eight approaches to APD described in the literature and its definitions by ten societies or groups from around the world.
The dominant conceptualisation of APD remains one of disorders (or at least deficits) in the bottom-up processing of sound in the primary auditory nervous system that are not due to higher order (top-down) language or cognitive deficits. Challenges to this conceptualisation question the relevance of (bottom-up) AP to listening, learning and language. These challenges are rejected by some groups who maintain the dominant bottom-up conceptualisation of APD, but accepted by others who suggest APD be reconceptualised to include top-down processing of sound or attempts to define APD be de-emphasised in favour of a hierarchical approach to listening difficulties.
To reconcile these challenges, the concept of APD could be better evolved by considering it as a spectrum disorder spanning from bottom-up AP to the top-down cognitive processes (particularly attention) that affect it.
探讨听觉处理障碍（APD）不断演变的概念。
叙述性综述及观点文章。
文献中描述的八种APD研究方法以及来自世界各地的十个协会或团体对其的定义。
APD的主流概念仍认为它是原发性听觉神经系统中自下而上的声音处理过程出现的障碍（或至少是缺陷），而非高阶（自上而下）语言或认知缺陷所致。对这一概念的挑战质疑了（自下而上的）听觉处理与听力、学习和语言的相关性。一些坚持APD主流自下而上概念的团体拒绝了这些挑战，但另一些团体则接受了这些挑战，他们建议重新定义APD，将声音的自上而下处理纳入其中，或者不再强调对APD的定义，转而采用分层方法来处理听力困难问题。
为了应对这些挑战，可以将APD视为一种谱系障碍，涵盖从自下而上的听觉处理到影响它的自上而下认知过程（特别是注意力），以此更好地发展APD的概念。
