Abstract
Objective: To consider the evolving concept of auditory processing disorder (APD). Design: Narrative review and opinion piece. Study sample: Eight approaches to APD described in the literature and its definitions by ten societies or groups from around the world. Results: The dominant conceptualisation of APD remains one of disorders (or at least deficits) in the bottom-up processing of sound in the primary auditory nervous system that are not due to higher order (top-down) language or cognitive deficits. Challenges to this conceptualisation question the relevance of (bottom-up) AP to listening, learning and language. These challenges are rejected by some groups who maintain the dominant bottom-up conceptualisation of APD, but accepted by others who suggest APD be reconceptualised to include top-down processing of sound or attempts to define APD be de-emphasised in favour of a hierarchical approach to listening difficulties. Conclusions: To reconcile these challenges, the concept of APD could be better evolved by considering it as a spectrum disorder spanning from bottom-up AP to the top-down cognitive processes (particularly attention) that affect it.
Acknowledgements
The author would like to thank the anonymous reviewers for their constructive feedback, much of which has been included directly in this article.
Declaration of interest: No potential conflict of interest was reported by the author.