Critical analysis of children with suspicion of auditory processing disorders (APD)

Background: APDs at infancy has become a common reason of introduction at phoniatric/peclaudiologic departments. The question arises whether this neurocognitive construct can be accounted with the standard clinical diagnostics. Methods: The children with suspicion of APD referred to the Department of Phoniatrics/Pedaudiology at the University Hospital Goettingen/ Germany were clinically examined. Patients: Of 107 children 8% demonstrated abnormal hearing acuity, 7% learning and intelligence disorders, 7% developmental dyslexia, 6% language impairments, and 5% attention deficit/hyperactivity. So, 59 children remained for evaluating for an APD (mean age: 85.3; SD 16.3 months). Results: Their auditory performances were normdeviant from 7% (speech audiometry) to 86% (auditory sequential short-term memory for non-words). 55% of the children exhibited a reduced dichotic word discrimination, 59% a performance below norm level in auditory sequential memory for digits, and 86% for non-words. Next step, the children of the study group were distributed according to their therapy situations at the time of examination: without; speech therapy; occupational therapy; speech therapy+occupational therapy. No significant group effects were found in the mean performances of the audiometric and psychometric tests, even though the results considerably differed. No auditory dimension made a contribution to separate the groups in a stepwise discriminant analysis. Conclusions: There was a notably inherent heterogeneity of the population presenting with auditory processing problems. The overall objective of the APD evaluation must be to assess processing skills apart from complex stimuli like language skills (e.g. parameter of tones, memory of tone pitch).