Background: A deficit in the processing of auditory information may underlie problems in understanding
speech in the presence of background noise, degraded speech, and in following spoken
instructions. Children with auditory processing disorders are challenged in the classroom
because of ambient noise levels and maybe at risk for learning disabilities.
Purpose: 1) Set up and execute screening protocol for auditory processing performance (APP)
in primary school children. 2) Construct database for APP in the classroom. 3) Set
critical limits for deviant performance. Our hypothesis is that screening for APP
in the classroom identifies pupils at risk for auditory processing disorders.
Research Design, Sample, and Methods: Study consisted of two phases. Phase 1: 2,015 pupils were selected from fourth-,
fifth-, and sixth-graders using stratified random sampling with the proportional allocation
method. Male and female students were equally represented. Otoscopic examination,
screening audiometery, and screening tests for auditory processing (AP) abilities
(Pitch Pattern Sequence Test [PPST], speech perception in noise [SPIN] right, SPIN
left, and Dichotic Digit Test) were conducted. A questionnaire emphasizing auditory
listening behaviors (ALB) was answered by classroom teacher. Phase 2 included 69 pupils
who were randomly selected based on percentile scores of phase 1. Students were examined
for the corresponding full version AP tests in addition to Auditory Fusion Test-Revised
and masking level difference. Intelligence quotient and learning disabilities were
evaluated.
Results: Phase 1: Results are displayed in frequency polygons for10th, 25th, 50th, 75th, and
90th percentiles score for each AP test. Fourth-graders scored significantly lower
than fifth- and sixth-graders on all tests. Males scored lower than females on PPST.
A composite score was calculated to represent a summed score performance for PPST,
SPIN right ear, SPIN left ear, and Dichotic Digit Test. Scores <10th percentile were
chosen to describe the poorest performance on screening. Performance was graded from
0 to 4 according to composite score; a score of 4 refers to scores <10th percentile
on all four tests, while a 0 score designates performance ≥ the 10th percentile on
all tests. ALB questionnaire scores of the sample screened varied significantly with
sex and grade. Statistical analysis of phase 2 showed no statistical difference between
mean score for Group 0 and clinic norms on all AP tests. Group 1 showed consistent
poor performance in both the screening and full version SPIN test. Group 2 scored
significantly lower on all screening tests, but not significantly different in some
of the full version tests. Groups 3 and 4 showed significantly worse performance than
clinic norms on all screening and full version tests. Auditory Fusion Test-Revised
mean thresholds were statistically higher for groups with composite scores from 1
to 4. Masking level difference mean score was only significantly different for Group
4. ALB questionnaire results correlated to composite score categories. Dyslexia was
a comorbid condition with Groups 2–4.
Conclusion: AP skills in primary education maybe classified as robust abilities that endure challenging
listening conditions, vulnerable abilities that manifest in challenging conditions,
and poor abilities that manifest in even the best listening conditions. Composite
score concept provides adequacy in grading AP skills.
Key Words
auditory processing - auditory processing disorders - children - learning - screening
