Auditory Processing Literature Review
In the past, there has been difficulty in defining what is known as (central) auditory processing disorder (CAPD), its definition is constantly changing with the most recent being produced by the American Speech-Language-Hearing Association (ASHA, 2005) stating that “(C)APD is a deficit in neural processing of auditory stimuli that is not due to higher order language, cognitive, or related factors” (ASHA, 2005; Wilson et al., 2012) however, this definition is not accepted by everyone (Kamhi, 2011). Attempts to clearly define CAPD and differentiate it from other disorders continue. There is an abundance of research that comments on the difficulty in the differential diagnosis of CAPD and the comorbidity of CAPD with other disorders (Cook et al., 1993; Gascon et al., 1986; Gomez et al., 1999; Keller et al., 2002; Riccio et al., 1994). The disorders most commonly associated with CAPD are Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) with many studies documenting the relationship between the two (Cook et al., 1993; Gascon et al., 1986; Gomez et al., 1999; Kamhi, 2011; Keller et al., 2002; Riccio et al., 1994). Furthermore it is important to obtain a better understanding of the processes used to differentially diagnose this disorder as well as the similarities between other disorders. The literature indicates that CAPD often occurs with other disorders, suggesting that a multidisciplinary approach may be most beneficial for correct diagnosis (Emanuel et al., 2011).
“The integrity of CAPD as a discreet diagnostic entity has been questioned by some researchers” (Cook et al., 1993). “Ludlow et al. (1983) described a weak link between CAPD and language disabilities in children” (Cook et al., 1993), Kamhi (2011) stated “we have expended too much time, energy, and resources trying to understand and treat a disorder that has not only defied definition, but lacks clear diagnostic criteria” and Wilson et al. (2012) “suggest that calls to abandon the use of (C)APD as a global label be supported”. While others (Gascon et all., 1986; Cook et al., 1993) have suggested that the diagnostic criteria for CAPD and ADD contain many features which make the disorders clinically similar. Many common characteristics of CAPD – poor attention and concentration, distractibility and fidgeting – are also clinical symptoms for a diagnosis of ADD and ADHD (Cook et al., 1993; Gomez et al., 1999). This similarity shows how easy a misdiagnosis can be due to the overlap in the behavioural symptoms of these disorders (Cook et al., 1993; Riccio et al., 1996). Emanuel et al. (2011) conducted a survey to determine the current protocols used by audiologists in diagnosing children with CAPD. A previous study conducted by Emanuel (2002) stated that there isn’t enough normative data on auditory processing disorder (APD) tests which complicates differential diagnosis. To date there is no consensus regarding the tests that should make up a basic auditory processing battery, “the most recent guidelines, published by ASHA (2005) and the American Academy of Audiology (AAA, 2010), indicate that APD assessment should not be driven by a minimum test battery, but instead the test battery should be based on the individual’s case history and other information provided to the audiologist” (Emanuel et al., 2011). This lack of consensus and clear diagnostic criteria (Emanuel et al., 2011; Kamhi, 2011) aids in the difficulty with differential diagnosis of the two disorders. Emanuel et al (2011) found that clinical audiologists were completing a relatively consistent approach towards the diagnosis of APD and included input from other multidisciplinary specialists. It was also found that those participating in the study believed that diagnosing APD and recommendations for treatment and management was the responsibility of the audiologist however they believed that speech-language...
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