Profile and aetiology of children diagnosed with auditory processing disorder (APD)
Introduction
APD is diagnosed on the basis of difficulty in identifying or discriminating sounds despite normal peripheral hearing. Difficulty in understanding speech in noise is the most common manifestation. Although it does not feature in mainstream diagnostic classifications such as DSM-IV or ICD-10, APD is becoming more widely diagnosed. However, controversy exists over the definition of APD, diagnosis, association with learning problems and causation. We studied a sample of children referred to a specialist APD clinic to describe and compare the presenting features of APD and non-APD children as well as to examine the role of various possible aetiological factors in APD.
Chermak and Musiek [31] noted that ADP cases with an obvious neurological aetiology are in the minority (∼5%). For the remainder, the concept of ‘neuro-developmental disorder’ or ‘maturational lag’ is usually invoked, but the aetiology of this is not clear and there is little evidence for the role of any particular risk factor. Inherited factors and/or obstetric complications may relate to neuro-developmental auditory processing problems while auditory deprivation due to otitis media has been suggested to underlie a maturational delay [1]. Musiek et al. [2] reported that a genetic contribution was suspected for some children with APD of ‘neuro-developmental origin’, with many having family histories of learning disabilities. Note, however, that Musiek et al. did not distinguish between learning problems such as specific language impairment (SLI), for which there is good evidence for heritability [3] and more specific auditory problems.
The first part of this article seeks to characterise children diagnosed with APD in comparison to children for whom an APD diagnosis is excluded (non-APD) in terms of terms of age, sex, co-morbid conditions and reported symptoms. The second part explores factors that may be significant in the aetiology of auditory processing problems.
Section snippets
Methods
Data were analysed retrospectively from a research database containing demographic details, case history, symptoms, co-morbid conditions, audiological test results and suspected aetiology. Information was entered into the database from medical case notes.
Presenting features
Proportion of males and females and average age were not significantly different between groups. The average age of the APD children was 10.3 (S.D. 2.6) and 10.1 for the non-APD group (S.D. 2.0). Average SCAN composite scores, average parental Fisher's checklist percentile and average parental CHAPS scores are shown in Table 1. There was no significant difference between average percentile score on Fisher's checklist or on total CHAPS score between groups.
Symptoms
Table 2 contains a list of symptoms
Aetiological factors
For the aetiological analysis, two children with an identifiable neurological cause for their auditory processing problems (Landau-Kleffner syndrome and Gaucher-related brainstem abnormalities) were excluded from the APD group.
Discussion
Among children referred for investigation of APD, there were no differences between those who did and did not receive an APD diagnosis, either in symptoms or co-morbid conditions. The CHAPS and Fisher's APD screening questionnaires also did not differentiate between groups. A high proportion of both APD and non-APDs had co-morbid conditions, especially those related to language and literacy. Overall, non-APD and APD children did not differ in any respect apart from performance on tests of
Acknowledgement
This research was funded by Deafness Research, UK.
References (32)
- et al.
Obstetric complications in autism: consequences or causes of the condition?
J. Am. Acad. Child Adolesc. Psychiatry
(1997) - et al.
Pathogenesis and genetics of pre-eclampsia
Lancet
(2001) - et al.
Incidence of reading disability in a population-based birth cohort, 1976–1982, Rochester, Minn
Mayo Clinic Proceed.
(2001) - et al.
Developmental coordination disorder in Swedish 7-year-old children
J. Am. Acad. Child Adolesc. Psychiatry
(1999) - et al.
Aetiology and clinical presentations of auditory processing disorders—a review
Arch. Dis. Childhood
(2001) - et al.
Profiles of types of central auditory processing disorders in children with learning disabilities
J. Childhood Commun. Disord.
(1985) What causes specific language impairment in children?
Curr. Dir. Psychol. Sci.
(2006)Survey of care pathway for auditory processing disorder
Audiol. Med.
(2006)SCAN—A: A Test for Auditory Processing Disorders in Adolescence and Adults
(1994)
Random Gap Detection Test
GIN (Gaps-In-Noise) Test performance in subjects with confirmed central auditory nervous system involvement
Ear Hear.
Frequency (pitch) and duration pattern tests
J. Am. Acad. Audiol.
Tests of central auditory function in children with learning disabilities
Duration pattern recognition in normal subjects and patients with cerebral and cochlear lesions
Audiology
Children's Auditory Performance Scale
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