Multidisciplinary clinical assessment and interventions for childhood listening difficulty and auditory processing disorder: Relation between research findings and clinical practice.

PURPOSE

Listening difficulty (LiD), often classified as auditory processing disorder (APD), has been studied in both research and clinic settings. The aim of this study was to examine the predictive relation between these two settings. In our "SICLiD" research study, children with normal audiometry, but caregiver-reported LiD, performed poorly on both listening and cognitive tests. Here we examined results of clinical assessments and interventions for these children in relation to research performance.

METHODS

Study setting was a tertiary pediatric hospital. Electronic medical records were reviewed for 64 children aged 6-13 years recruited into a SICLiD LiD group based on a caregiver report (ECLiPS). The review focused on clinical assessments and interventions provided by Audiology, Occupational Therapy, Psychology (Developmental and Behavioral Pediatrics), and Speech-Language Pathology services, prior to study participation. Descriptive statistics on clinical encounters, identified conditions, and interventions were compared with quantitative, standardized performance on research tests. Z-scores were compared for participants with and without each clinical condition using univariate and logistic prediction analyses.

RESULTS

Overall, 24 clinical categories related to LiD, including APD, were identified. Common conditions were attention (32%), language (28%), hearing (18%), anxiety (16%), and autism spectrum (6%) disorders. Performance on research tests varied significantly between providers, conditions, and interventions. Quantitative research data combined with caregiver reports provided reliable predictions of all clinical conditions except APD. Individual test significant correlations were scarce, but included the SCAN composite score, which predicted clinical language and attention difficulties, but not APD diagnoses.

CONCLUSIONS

The variety of disciplines, assessments, conditions and interventions revealed here supports previous studies showing that LiD is a multifaceted problem of neurodevelopment. Comparisons between clinical- and research-based assessments suggest a path that prioritizes caregiver reports and selected psychometric tests for screening and diagnostic purposes.