Karin Neijenhuis

Age effects and normative data on a Dutch test battery for auditory processing disorders.

A test battery compiled to diagnose auditory processing disorders (APDs) in an adult population was used on a population of 9–16-year-old children. The battery consisted of eight tests (words-in noise, filtered speech, binaural fusion, dichotic digits, frequency and duration patterns, backward masking, categorical perception, digit span) and a questionnaire. Descriptive statistics were computed on data obtained from 75 children from primary school (age 9–12 years) and 30 adolescents from secondary school (age 14–16 years) with normal hearing and normal intelligence. Most test scores did not follow a normal distribution. Age effects were present in most tests, within the group as well as when children and adolescents were compared to adults. This suggests that maturation of auditory processing abilities takes place even during adolescence. Relative measures regarding ear differences and binaural versus monaural scores did not appear to be age-related. These measures might be useful in diagnosing APD, supplementary to the absolute measures. Factor analysis showed four components that address underlying processes. However, these results must be interpreted cautiously because the study did not include any subjects with APD. Sumario Una bateria de pruebas elaborada para diagnosticar problemas de procesamiento auditivo (APD) en adultos fue utilizada en una población de 9 a 16 años. Esta serie estaba constituida por ocho pruebas (palabras en ruido, lenguaje filtrado, fusión binaural, digitos dicótícos, patrones de frecuencia y duración, enmascaramienlo invertido. percepción de calegorías, memoria de dígitos a corto plazo) y un cuestionario. Se presenta una estadística descriptiva obtenida de 75 niños de escucla primaria (edad 9–12 años) y 30 adolescentes de secundaria (edad 14–16 años) con audición e inteligcncia normales. La mayor parte de los resultados de las pruebas no mostraron una distribución normal. En la mayor parte de ellas, la edad luvo un efecto dentro de cada grupo y también al comparar a los niños y adolescentes con los adultos. Esto sugiere que la maduración de las habilidades en el procesamiento auditivo ocurre incluso durante la adolescencia. Al parecer no hay una influencia de la edad sobre los resultados concernientes a latcralidad o binauralidad vs monoauralidad. Es posible que estas mediciones sean utiles en forma complementaria a las mediciones absolutas de los APD. El análisis factorial demuestra cuatro componentes que señalan procesos subyacentes. Sin embargo, estos resultados deben ser interpretados cautelosamente porque el estudio no incluyó a ningún sujeto con APD.

Auditory processing disorders in adults and children: evaluation of a test battery.

A Dutch test battery comprising six different tests for auditory processing disorders was evaluated in a group of 49 adults and children (age 8–57 years) with auditory complaints despite normal audiometric thresholds. Percentile scores were derived from normal control groups (n = 132) to determine whether a subject passed or failed a test. A composite score was computed to reflect a general score on all the auditory processing tests. In order to gain insight into underlying auditory processes, factor analysis was performed. Normal scores on all the tests were seen in five subjects. The remaining 44 subjects had at least one test score that was below the cut-off point (10th percentile). Factor analysis provided evidence for a model comprising four auditory components: auditory sequencing, word recognition in noise, auditory closure, and auditory patterning. This model could be useful in the interpretation of scoring patterns. Although there were some differences in scoring patterns between the children and adults, the test battery proved to be useful in both groups.

Evaluation of auditory processing disorders after whiplash injury

Whiplash patients often have many subjective complaints, such as headaches, concentration difficulties, fatigue, neck pain and vertigo. Objective assessment of these complaints is difficult and neurological and neuropsychological signs of damage are not obvious. Other complaints frequently expressed after whiplash injury are diminished speech intelligibility in noisy environments and decreased tolerance to ‘loud’ sounds. In the present study, the latter complaints were evaluated with behavioural auditory tests. A test battery for auditory processing disorders was administered to 22 chronic whiplash patients with normal peripheral hearing. The test battery consists of seven tests: a sentences-in-noise test, pattern recognition tests, words-in-noise test, dichotic digit test, filtered speech test, binaural fusion test and backward masking tests. The uncomfortable loudness level (UCL) was also assessed using speech material. In addition, a questionnaire on auditory handicap was administered. The results were compared to those obtained from a control group of 28 healthy subjects with normal hearing. Significant differences were found on all subtests between the whiplash patients and the control group, except for the sentences in continuous noise test, the filtered speech test and the binaural fusion test. Whiplash subjects scored at least two tests below the 10th percentile of the control group. The UCL was significantly lower in the whiplash group. Correlation analyses showed a relationship between the subjective complaints reported in the questionnaire and several test scores. Test results indicate that the whiplash patients had auditory processing disorders, although headaches and attentional deficits might interfere with auditory test performance. The AP test battery proved to be useful in assessing the auditory processing problems of whiplash patients.

Perspectives of Dutch health professionals regarding auditory processing disorders; a focus group study

Abstract Objective: This study investigated the perspectives of professionals from the Dutch audiological centres on the definition and care pathways of children with suspected auditory processing disorders (susAPD). Design: focus group interviews. Study sample: In total, 45 professionals from 6 disciplines, representing 22 different audiological centres and one ambulatory service, participated in five parallel focus group interviews. Participants had a variety of experience in diagnosing and advising children with suspected APD. Results: Qualitative analysis (open and thematic) identified four themes (“Definition”, “Causes”, “Diagnostic Procedures” and “Clinical Reasoning”) expressing a variety of perspectives. Differences in perspectives were mainly affected by two debates: (1) whether or not APD exists as a pure (auditory) disorder and (2) whether or not current AP-tests are suitable in diagnosing children with listening difficulties. They also expressed a need for more guidance from the literature in their clinical decision making process. Conclusions: Professionals from the Dutch audiological centres share a broad perspective on children with APD. The ICF framework supports this perspective, thereby diminishing the need for a clear definition. The use of AP-tests should be limited to children where broader developmental disorders are first ruled out; a possible “pure” APD could then be diagnosed in a limited number of children.

Acoustic environments that support equally accessible oral higher education as a human right

Abstract Purpose: People have the right to freedom of opinion and expression, as defined in Article 19 of the Universal Declaration of Human Rights. Higher education plays a major role in helping students to develop and express their own opinions and, therefore, should be equally accessible to all. This article focuses on how students judge the accessibility to oral instruction in higher education listening contexts. Method: We collected data from 191 students in higher education by means of a questionnaire, addressing understanding speech in different types of classrooms and various educational settings. Result: In lecture halls, understanding speech was judged to be significantly worse than in smaller classrooms. Two important negative factors were identified: background noise in classrooms and lecture halls and the non-use of a microphone. Conclusions: In lecture halls students achieve good or excellent speech perception only when lecturers are using a microphone. Nevertheless, this is not a standard practice. To achieve genuine inclusion in tertiary education programs, it is essential to remove acoustic barriers to understanding speech as much as possible. This study is a first step to identify communication facilitators to oral higher education instruction, for students with hearing loss or communication impairment.