Auditory processing disorders in children – diagnosisand management

Abstract

Introduction: Auditory Processing Disorders (APD) is a syndrome characterized by impairment of the perception of soundsverbal and non-verbal ones, and weakening cognitive abilities such as auditory attention and auditory memory. This symptoms occur despite correct functioning of the peripheral part of the organ of hearing. Aim: A review of the current literature on diagnostic criteria of APD and its subtypes, clinical symptoms in children, diagnostic procedures and methods and therapeutic interventions. Methods: The study was based on the guidelines of the British Audiological Society (BSA), the guidelines of the American Speech, Language and Hearing Society (ASHA) as well as a literature review in the PubMed database. Results: APD is divided into developmental (without an established cause), acquired (with an established cause) and secondary (a consequence of long-term peripheral hearing loss). Symptoms that indicate the likelihood of APD in schoolaged children include: poor school performance, problems with learning to read and write and understanding speech, difficulties in repeating and remembering information given by hearing and maintaining attention on the spoken word. APD diagnosis should be made by a specialist in audiology and phoniatrics based on a full battery of tests and consultations with a speech therapist, psychologist and pedagogue. The set of behavioral diagnostic tests should include both verbal and non-verbal tests, from at least three groups of tests: dichotic (e.g. dichotic digit test; DDT), evaluating temporal aspects of hearing (e.g. Frequency Pattern Test; FPT and Duration Pattern Test; DPT ) and low redundancy speech tests. The diagnosis can be made when the child is at least 7 years old, the result is below the norm in at least two tests evaluating different auditory processes and the child has previous been excluded from intellectual disability and autism spectrum disorders. The therapeutic procedure is based on active auditory training, specific for the deficit shown in the tests. It is important to improve the acoustic environment at school (FM systems) and to treat comorbidities. Conclusions: Diagnostics and therapy of APD requires a highly qualified team of specialists and should be carried out in centers specially prepared for this purpose.