Auditory Processing Disorders: Putting the “Neural” Back into Sensorineural Hearing Loss

Address correspondence to: Prudence Allen, Ph.D., Associate Professor, School of Communication Sciences and Disorders, Director, National Centre for Audiology, Faculty of Health Sciences, Room 2262 Elborn College, University of Western Ontario, London, Ontario N6G 1H1, [email protected]. tivity that underlies that processing....” (p. 2). This implies that one should be studying not only the impact of such a disorder as would be evidenced in the processing of degraded or competing speech, but also that as clinicians we should study auditory perceptual abilities and electrophysiological markers of auditory system integrity. In their recommendations for the evaluation of auditory processing and disorders thereof, Jerger and Musiek (2000) recommend, among many behavioral tests, objective assessment, including such measures as auditory brainstem responses, middle and late auditory evoked potentials, and acoustic reflexes. Yet the use of these objective measures has been questioned (Katz et al. 2002) largely due to a lack of data supporting the presence of abnormal responses in individuals with auditory processing disorders and the lack of data showing a possible relationship between behavioral and objective measures. In clinical practice the use of electrophysiologic tests falls behind that of behavioral tests (Emanuel 2002). We have undertaken a fairly large-scale study of auditory processing and related abilities in young children. Our approach includes an evaluation of auditory system integrity and an assessment of a wide range of behaviors. Only through evaluating both auditory and related behaviors and neural integrity will we better understand the relationship between the two. Here we present some of that physiologic data and a few case studies illustrating potential impacts on behavioral function. Sixty-four children with suspected auditory learning disabilities were included in this study. Forty were male, 24 were female. Ages ranged from 7 to 17 years with a mean age of 9.97 years. Referrals came from local pediatricians, audiologist, teachers, principles, and parents. Each child was suspected of having difficulty learning through auditory modality and/or showed signs of problems with auditory attention. All children except one