Loo, H.Y.J.; (2012) Management of children with auditory processing disorder. Doctoral thesis , UCL (University College London).

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Abstract

Recent advances in auditory neuroscience have expanded our understanding of auditory processing disorder (APD) – a hearing/listening disorder that is characterized by poor perception of speech and non-speech sounds, which results from atypical neural function predominantly in the brain (BSA, 2011). The main purpose of this thesis was to examine the effectiveness of a self-developed computer-based auditory training (CBAT) intervention for children with APD. A systematic review conducted showed that very few studies report on a well-defined APD population, and many studies do not include untrained comparison group to tease out maturational or practice effect from true treatment effect, highlighting significant limitations of the existing evidence of CBAT for children with APD. In view of the current absence of a 'gold standard' test battery for the diagnosis of APD, a review of a clinical database was conducted to inform the suitability of the type of auditory processing (AP) tests to be used in the main study. While both speech and non-speech AP tests are commonly used for clinical diagnosis purposes, the findings of this retrospective study showed that the current speech-based AP tests cannot be transferred readily across cultures. Non-speech AP tests, which are less influenced by individual's linguistic background and language competency, are therefore deemed more suitable to be used in a diverse community with multilinguals, where the main study was to be conducted. To help inform the feasibility and suitability of the current CBAT, a pilot study was conducted on 3 neurologically abnormal (PAX6 gene mutations) children with APD. The results showed some broad improvement among these children after 3 months of intervention. By applying the same principle with modifications to the study design, a group of neurologically normal children with APD was randomised to training (n=20) and control (n=19) groups. The AP skills of the trained group improved significantly more than that of the untrained controls; such improvement lasted for at least 3 months. The improved AP skill was also consistent with the improvement observed in the functional skill in the trained group as reported by the teachers. Finally, neither the language nor cognitive skills was predictive of the training outcome, but the initial AP skills did.

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