Multidimensional Approach to the Differential Diagnosis of Central Auditory Processing Disorders in Children

Abstract

Central auditory processing disorder (CAPD) may be viewed as a multidimensional entity with far-reaching communicative, educational, and psychosocial implications for which differential diagnosis not only is possible but also is essential to an understanding of its impact and to the development of efficacious, deficit-specific management plans. This paper begins with a description of some behavioral central auditory assessment tools in current clinical use. Four case studies illustrate the utility of these tools in clarifying the nature of auditory difficulties. Appropriate treatment options that flow logically from the diagnoses are given in each case. The heterogeneity of the population presenting with auditory processing problems, not unexpected based on this model, is made clear, as is the clinical utility of central auditory tests in the transdisciplinary assessment and management of children's language and learning difficulties.

Abbreviations: ADD = attention deficit disorder, ALD = assistive listening device, BF = binaural fusion, BF-CVC = consonant-vowel-consonant binaural fusion, CAPD = central auditory processing disorder, CST = Competing Sentences Test, DD = Dichotic Digits, DP = Duration Patterns, DR = Dichotic Rhyme, FP = frequency patterns, LPFS = low-pass filtered speech, RASP = Rapidly Alternating Speech Perception, SPN = speech in noise, SSW = Staggered Spondaic Words, TC = time-compressed speech, TCR = time-compressed speech with reverberation

Key Words

Central auditory processing disorder - children

Publication History

Article published online:
29 April 2022

• REFERENCES

• American Speech-Language-Hearing Association. (1996). Central auditory processing: current status of research and implications for clinical practice. Task force on central auditory processing consensus development. Am J Audiol 5:41–54.
• Baran JA, Verkest S, Gollegly K, Kihbe-Michal K, Rintelmann WF, Musiek FE. (1985). Use of compressed speech in the assessment of central nervous system disorder. J Acoust Soc Am 78(Suppl 1):S41.
• Bellis TJ. (1996). Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: From Science to Practice. San Diego: Singular.
• Bellis TJ, Ferre JM. (1996). Assessment and management of CAPD in children. Educ Audiol Monogr 4:23–27.
• Cacace AT, McFarland DJ. (1998). Central auditory processing disorder in school-aged children: a critical review. J Speech Lang Hear Res 41:355–373.
• Chermak GD, Musiek FE. (1997). Central Auditory Processing Disorders: New Perspectives. San Diego: Singular.
• Dimond SJ, Scammell RE, Brouwers EY, Weeks R. (1977). Functions of the centre section (trunk) of the corpus cal-losum in man. Brain 100:543–562.
• Ferre JM. (1987). Pediatric central auditory processing disorder: considerations for diagnosis, interpretation, and remediation. J Acad Rehabil Audiol 20:73–81.
• Ferre JM. (1997). Processing Power: A Guide to CAPD Assessment and Management. San Antonio, TX: The Psychological Corporation.
• Jerger J, Jerger S. (1975). Clinical validity of central auditory tests. Scand Audiol 4:147–163.
• Katz J. (1962). The use of staggered spondaic words for assessing the integrity of the central auditory nervous system. J Auditory Res 2:327–337.
• Katz J, Wilde L. (1985). Auditory perceptual disorders in children. In: Katz J, ed. Handbook of Clinical Audiology. 3rd Ed. Baltimore: Williams and Wilkins, 664–688.
• Keith R. (1977). Synthetic sentence identification test. In: Keith RW, ed. Central Auditory Dysfunction. New York: Grune and Stratton, 73–102.
• Klouda GV, Robin DA, Graff-Radford NR, Cooper WE. (1988). The role of callosal connections in speech prosody. Brain Lang 35:154–171.
• Koch DB, McGee TJ, Bradlow AR, Kraus N. (1999). Acoustic-phonetic approach toward understanding neural processes and speech perception. J Am Acad Audiol 10:000–000.
• Kraus Ν, McGee Τ, Carrell Τ, Zecker Ν, Nicol Τ, Koch D. (1996). Auditory neurophysiologic responses and discrimination deficits in children with learning problems Science 273:971–973.
• Lepore F, Lassonde M, Poirier P, Schiavetto A, Veillette N. (1994). Midline sensory integration in callosal agenesis. In: Lassonde M, Jeeves MA, eds. Callosal Agenesis: A Natural Split Brain? New York: Plenum Press, 155–169.
• Lynn GE, Gilroy J. (1977). Effects of brain lesions on the perception of monotic and dichotic speech stimuli. In: Sullivan MD, ed. Central Auditory Processing Disorders. Proceedings of a conference at the University of Nebraska Medical Center, Omaha, 47–83.
• McFarland DJ, Cacace AT. (1995). Modality specificity as a criterion for diagnosing central auditory processing disorders. Audiology 36:249–260.
• Musiek FE. (1983a). Assessment of central auditory dysfunction: the dichotic digits test revisited. Ear Hear 4:79–83.
• Musiek FE. (1983b). The evaluation of brainstem disorders using ABR and central auditory tests. Monogr Contemp Audiol 4:1–24.
• Musiek FE, Chermak GD. (1995). Three commonly asked questions about central auditory processing disorders: management. Am J Audiol 4:15–18.
• Musiek FE, Kibbe K, Baran JA. (1984). Neuroaudiological results from split-brain patients. SeminHear 5:219–229.
• Musiek FE, Kurdziel-Schwan S, Kibbe KS, Gollegly KM, Baran JA, Rintelmann WF (1989). The dichotic rhyme task: results in split-brain patients. Ear Hear 10:33–39.
• Musiek FE, Pinheiro ML, Wilson DH. (1980). Auditory pattern perception in "split-brain" patients. Arch Otolaryngol 106:610–612.
• Pinheiro ML, Musiek FE. (1985). Sequencing and temporal ordering in the auditory system. In: Pinheiro ML, Musiek FE, eds. Assessment of Central Auditory Dysfunction: Foundations and Clinical Correlates. Baltimore: Williams and Wilkins, 219–238.
• Pinheiro ML, Ptacek PH. (1971). Reversals in the perception of noise and tone patterns. J Acoust Soc Am 49:1778–1782.
• Ptacek PH, Pinheiro ML. (1971). Pattern reversal in auditory perception. J Acoust Soc Am 49:493–498.
• Rees NS. (1973). Auditory processing factors in language disorders: the view from Procrustes' bed. J Speech Hear Disord 38:304–315.
• Rees NS. (1981). Saying more than we know: is auditory processing disorder a useful concept? In: Keith RW, ed. Central Auditory and Language Disorders in Children. San Diego: College-Hill Press, 94–120.
• Tomkins C. (1995). Right Hemisphere Communication Disorders. Theory and Management. San Diego: Singular.
• Tonal and Speech Materials for Auditory Perceptual Assessment. (1992). Long Beach, CA: Research and Development Service, Veterans'Administration Central Office.
• Watson BU, Miller TK. (1993). Auditory perception, phonological processing, and reading ability/disability. J Speech Hear Res 36:850–863.
• Willeford JA. (1977). Assessing central auditory behavior in children: a test battery approach. In: Keith RW, ed. Central Auditory Dysfunction. New York: Grune and Stratton, 43–72.
• Willeford JA, Bilger JM. (1978). Auditory perception in children with learning disabilities. In: Katz J, ed. Handbook of Clinical Audiology 2nd Ed. Baltimore: Williams and Wilkins, 410–425.
• Willeford JA, Burleigh JM. (1994). Sentence procedures in central auditory testing. In: Katz J, ed. Handbook of Clinical Audiology. 4th Ed. Baltimore: Williams and Wilkins, 259–268.
• Wilson L, Mueller HG. (1984). Performance of normal hearing individuals on Auditec filtered speech tests. ASHA 27:189.