Semin Hear 2002; 23(4): 297-308
DOI: 10.1055/s-2002-35878
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Auditory Training: Principles and Approaches for Remediating and Managing Auditory Processing Disorders

Gail D. Chermak1 , Frank E. Musiek2
  • 1Department of Speech and Hearing Sciences, Washington State University, Pullman, Washington
  • 2Department of Communication Sciences and Otolaryngology, University of Connecticut, Storrs, Connecticut
Further Information

Publication History

Publication Date:
04 December 2002 (online)


Recent reports suggest that auditory training (AT) can serve as a valuable intervention tool, particularly for individuals with language impairment and auditory processing disorder (APD). This article suggests a continuum of AT approaches, including those that do not require major instrumentation and can be implemented by speech-language pathologists and audiologists through their clinical practices. AT approaches are categorized as formal and informal. Formal AT is conducted by the professional in a controlled setting. Informal AT can be conducted as part of a home or school management program for APD. Formal AT employs acoustically controlled, bottom-up tasks using tones and speech elements, as well as language-based or top-down tasks. Informal AT is designed to improve auditory perceptual skills through language-based, predominantly top-down tasks. Coupling formal with informal AT should maximize treatment efficacy as skills are practiced toward mastery and automatism in real world settings that establish functional significance and provide repeated opportunities for generalization of skills.


  • 1 Edeline J M, Weinberger N M. Thalamic short-term plasticity in the auditory system: associative retuning of receptive fields in the ventral medial geniculate body.  Behav Neurosci . 1991;  105 618-639
  • 2 Elbert T, Pantev C, Wienbruch C, Rockstroh B, Taub E. Increased cortical representation of the fingers of the left hand in string players.  Science . 1995;  270 305-306
  • 3 Hassamannova J, Myslivecek J, Novakova V. Effects of early auditory stimulation on cortical areas. In: Syka J, Aitkin L, eds. Neuronal Mechanisms of Hearing New York: Plenum Press 1981: 355-359
  • 4 Irvine D RF, Rajan R, McDermott H J. Injury-induced reorganization in adult auditory cortx and its perceptual consequences.  Hearing Res . 2000;  147 188-199
  • 5 Knudsen E I. Experience shapes sound localization and auditory unit properties during development in the barn owl. In: Edlman G, Gall W, Kowan W, eds. Auditory Function: Neurobiological Basis of Hearing New York: John Wiley 1988: 137-152
  • 6 Merzenich M, Jenkins W. Cortical plasticity, learning and learning dysfunction. In: Julesz B, Kovacs I, eds. Maturational Windows and Adult Cortical Plasticity: SFI Studies in the Sciences of Complexity, vol. XXIII Reading, PA: Addison-Wesley 1995: 247-272
  • 7 Moore D R. Plasticity of binaural hearing and some possible mechanisms following late-onset deprivation.  J Am Acad Audiol . 1993;  4 227-283
  • 8 Recanzone G H, Schreiner C E, Hradek G. Functional reorganization of the primary auditory cortex I adult owl monkeys parallel improvements in performance in an auditory frequency discrimination task (Abst).  Soc Neurosci . 1991;  17(213.2) 534
  • 9 Recanzone G H, Schreiner C E, Merzenich M M. Plasticity in the frequency representation of primary auditory cortex following discrimination training in adult owl monkeys.  J Neurosci . 1993;  13 87-103
  • 10 Weinberger N M, Diamond D M. Physiological plasticity in auditory cortex: rapid induction by learning.  Prog Neurobiol . 1987;  29 1-55
  • 11 Willott J F, Aitken L M, McFadden S L. Plasticity of auditory cortex associated with sensorineural hearing loss in adult mice.  J Comp Neurol . 1993;  329 402-411
  • 12 Jirsa R E. The clinical utility of the P3 AERP in children with auditory processing disorders in school-aged children.  J Speech Hear Res . 1992;  35 903-912
  • 13 Merzenich M M, Jenkins W M, Johnston P. Temporal processing deficits of language-learning impaired children ameliorated by training.  Science . 1996;  271 77-80
  • 14 Musiek F E. Habilitation and management of auditory processing disorders: overview of selected procedures.  J Am Acad Audiol . 1999;  10 329-342
  • 15 Musiek F E, Schochat E. Auditory training and central auditory processing disorders: a case study.  Semin Hear . 1998;  19 357-366
  • 16 Tallal P, Miller S, Bedi G. Language comprehension in language-learning impaired children improved with acoustically modified speech.  Science . 1996;  271 81-84
  • 17 Katz J, Chertoff M, Sawusch J. Dichotic training.  J Audiol Res . 1984;  24 251-264
  • 18 Chermak G D, Musiek F E. Managing central auditory processing disorders in children and youth.  Am J Audiol . 1992;  1 61-65
  • 19 Chermak G D, Musiek F E. Central Auditory Processing Disorders: New Perspectives.  San Diego, CA: Singular 1997
  • 20 >American Speech-Language-Hearing Association Task Force on Central Auditory Processing Development. Central auditory processing: current status of research and implications for clinical practice.  Am J Audiol . 1996;  5(2) 41-54
  • 21 Jerger J, Musiek F. Report of the consensus conference on the diagnosis of auditory processing disorders in school-aged children.  J Am Acad Audiol . 2000;  11 467-474
  • 22 Kolb B. Brain Plasticity and Behavior.  Mahwah, NJ: Lawrence Erlbaum 1995
  • 23 Kalil R. Synapse formation in the developing brain.  Sci Am . 1989;  261 76-87
  • 24 Black J E. How a child builds its brain: some lesions from animal studies of neural plasticity.  Prev Med . 1998;  27 168-171
  • 25 Picheny M, Durlach N, Braida L. Speaking clearly for the hard of hearing: intelligibility differences between clear and conversational speech.  J Speech Hear Res . 1985;  28 96-103
  • 26 Bain B, Dollaghan C. Treatment efficacy: the notion of clinically significant change.  Lang Speech Hear Serv School . 1991;  22 264-270
  • 27 Olswang L B, Bain B. Data collection: monitoring children's treatment progress.  Am J Speech Lang Pathol . 1994;  3(3) 55-66
  • 28 Yencer K A. The effects of auditory integration training for children with central auditory processing disorders.  Am J Audiol . 1998;  7 32-44
  • 29 Anderson K L. S.I.F.T.E.R.: Screening Instrument for Targeting Educational Risk.  Austin, TX: Pro Ed 1989
  • 30 Anderson K L, Smaldino J. Listening Inventories for Education (L.I.F.E.)  Tampa, Fl: Educational Audiology Assoc 1998
  • 31 Smoski W J, Brunt M A, Tannahill J C. Listening characteristic of children with central auditory processing disorders.  Lang Speech Hear Serv School . 1992;  23 145-152
  • 32 Schlanger B. Effects of listening training on auditory thresholds of mentally retarded children.  ASHA . 1962;  4 273-274
  • 33 Pinheiro M L. Auditory pattern reversal in auditory perception in patients with left and right hemisphere lesions.  Ohio J Speech Hear . 1977;  12 9-20
  • 34 Musiek F E, Baran J A, Pinheiro M L. Duration pattern recognition in normal subjects and in patients with cerebral and cochlear lesions.  Audiology . 1990;  29 304-313
  • 35 McCrosky R L, Keith R W. The auditory fusion test-revised. St.  Louis, MO: Auditec 1996
  • 36 DiSimoni F G. The Token Test for Children.  Allen, TX: University Park Press 1978
  • 37 Keith R W. The Auditory Continuous Performance Test.  San Antonio, TX: The Psychological Corp 1994
  • 38 Sanders D A. Aural Rehabilitation.  Englewood Cliffs, NJ: Prentice Hall 1971
  • 39 Hetu R, Gagnon-Ttuchon C, Bilideau S. Problems of noise in school settings: a review of literature and the results of an exploratory study.  J Speech Pathol Audiol . 1990;  14 31-39
  • 40 Sloan C. Treating Auditory Processing Difficulties in Children.  San Diego, CA: College Hill Press 1986
  • 41 Musiek F E, Chermak G D. Three commonly asked questions about central auditory processing disorders: management.  Am J Audiol . 1995;  4 15-18
  • 42 Tye-Murray N. Foundation of Aural Rehabilitation.  San Diego, CA: Singular 1998
  • 43 Goldinger S D, Pisoni D B, Luce P A. Speech perception and spoken word recognition: research and theory. In: Lass NJ, ed. Principles of Experimental Phonetics St. Louis, MO: Mosby 1996: 277-327
  • 44 Cutler A, Foss D J. On the role of sentence stress in sentence processing.  Lang Speech . 1977;  20 1-10
  • 45 Studdert-Kennedy M. Speech perception.  Lang Speech . 1980;  23 46-66
  • 46 Valett R E. Developing linguistic auditory memory patterns.  J Lear Disabil . 1983;  16 462-466
  • 47 Handel S. Listening: An Introduction to the Perception of Auditory Events.  Cambridge, MA: MIT Press 1989
  • 48 Bornstein S P, Musiek F E. Implication of temporal processing for children with learning and language problems. In: Beasley D, ed. Contemporary Issues in Audition San Diego, CA: College-Hill Press 1984: 25-65
  • 49 Thompson M, Abel S. Indices of hearing in patients with central auditory pathology. II: Choice response time.  Scand Audiol . 1996;  21 17-22
  • 50 Cole R, Jakimik J. A model of speech perception. In: Cole R, ed. Perception and Prediction of Fluent Speech Mahwah, NJ: Lawrence Erlbaum 1980: 133-160