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Original

Auditory processing disorder in relation to developmental disorders of language, communication and attention: a review and critique

Research Report

&
Pages 440-465 | Received 18 Oct 2007, Accepted 26 Mar 2008, Published online: 10 Aug 2009
 

Abstract

Background: Auditory Processing Disorder (APD) does not feature in mainstream diagnostic classifications such as the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV), but is frequently diagnosed in the United States, Australia and New Zealand, and is becoming more frequently diagnosed in the United Kingdom.

Aims: To familiarize readers with current controversies surrounding APD, with an emphasis on how APD might be conceptualized in relation to language and reading problems, attentional problems and autistic spectrum disorders.

Methods & Procedures: Different conceptual and diagnostic approaches adopted by audiologists and psychologists can lead to a confusing picture whereby the child who is regarded as having a specific learning disability by one group of experts may be given an APD diagnosis by another. While this could be indicative of co-morbidity, there are concerns that different professional groups are using different labels for the same symptoms.

Conclusions & Implications: APD, as currently diagnosed, is not a coherent category, but that rather than abandoning the construct, we need to develop improved methods for assessment and diagnosis, with a focus on interdisciplinary evaluation.

Notes

1. The SCAN tests are individually administered in audiometric or quiet room conditions. Stimuli are recorded on a CD and presented over headphones. Patients are scored on the accuracy with which they repeat monotically presented single-word stimuli that have been acoustically degraded or presented in the presence of multi-talker babble, as well as dichotically presented single words and sentences. Accuracy scores are compared with age-based performance norms.

2. The ACPT is designed to measure a child's ability to attend and respond selectively to a specific linguistic cue and to maintain attention for an extended period of time. Tape-recorded stimuli are presented at a rate of one word per second. Children must listen for and respond by a thumb raise to the infrequent target word ‘dog’ presented randomly among other single syllable words. Comparison against criterion scores yields either a pass or a fail.

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