Moore David R, Lin Li, Bhalerao Ritu, Caldwell-Kurtzman Jody, Hunter Lisa L
Division of Patient Services Research, Cincinnati Children's Hospital Medical Center, OH.
Departments of Pediatrics and Otolaryngology-Head & Neck Surgery, University of Cincinnati, OH.
medRxiv. 2024 Nov 30:2024.06.12.24308837. doi: 10.1101/2024.06.12.24308837.
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.
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.
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.
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.
听力困难（LiD）通常被归类为听觉处理障碍（APD），已在研究和临床环境中进行了研究。本研究的目的是检验这两种环境之间的预测关系。在我们的“SICLiD”研究中，听力测定正常但照顾者报告有LiD的儿童在听力和认知测试中表现不佳。在此，我们研究了这些儿童的临床评估和干预结果与研究表现之间的关系。
研究地点为一家三级儿科医院。对64名6至13岁的儿童进行了电子病历审查，这些儿童基于照顾者报告（ECLiPS）被纳入SICLiD听力困难组。审查重点是在参与研究之前，听力学、职业治疗、心理学（发育与行为儿科学）以及言语语言病理学服务所提供的临床评估和干预。将临床会诊、确诊疾病和干预的描述性统计数据与研究测试中的定量标准化表现进行比较。使用单变量和逻辑预测分析比较有无每种临床疾病的参与者的Z分数。
总体而言，共确定了24个与LiD相关的临床类别，包括APD。常见疾病有注意力障碍（32%）、语言障碍（28%）、听力障碍（18%）、焦虑症（16%）和自闭症谱系障碍（6%）。不同提供者、疾病和干预措施下的研究测试表现差异显著。定量研究数据与照顾者报告相结合，对除APD外的所有临床疾病都提供了可靠的预测。个体测试的显著相关性较少，但包括SCAN综合评分，该评分可预测临床语言和注意力困难，但不能预测APD诊断。
此处揭示的多学科、评估、疾病和干预措施的多样性支持了先前的研究，表明LiD是一个神经发育的多方面问题。基于临床和研究的评估之间的比较为筛查和诊断目的优先考虑照顾者报告和选定的心理测量测试提供了一条途径。
