New Zealand Guidelines on Auditory Processing Disorder
Keith, W. J., Purdy, S. C., et al. (2019).
Auckland (New Zealand): New Zealand Audiological Society, Retrieved September 19, 2019 from https://www.audiology.org.nz/.
This is a guideline from the New Zealand Audiological Society on the identification, referral, diagnosis, and management of auditory processing disorders in children and adults.
New Zealand Audiological Society
For treating auditory processing disorder, computer-based auditory training programs should be used under professional guidance. Programs may target dichotic training or spatial perception.
When diagnosing auditory processing disorder (APD) in children and adults, "diagnosis is based on all available information, not just test scores. Diagnosis should be limited to a 'provisional' diagnosis, or a diagnosis of 'at risk for APD' in cases where there is incomplete information due to age or other factors" (p. 51). When diagnosis relies on a single test result, outcomes should be reassessed and reconfirmed. See the full guideline document for specific diagnostic criteria recommended by the New Zealand Audiological Society.
For assessing auditory processing disorder, "it is recommended that pre-assessment of children includes non-verbal cognitive ability and language assessments. If comprehensive pre-assessment information on language and cognitive ability is not available, audiologists and special education personnel can screen non-verbal intelligence, language, and phonological awareness using the TONI-4, the CELF-5 Screener, and the PIPA, QUIL, CTOPP, or TAPS-4. Attention can be screened by questionnaire (e.g., Lack of Attention Scale of the MBC), or by test (e.g., TEA-Ch or IVA CPT-2). Auditory short term memory can be screened using the TAPS-4. The COVD QOL questionnaire is recommended to screen for children who should be referred for assessment by a behavioural optometrist. The MoCA can be used for cognitive screening of adults" (p. 33).
"Early detection of and intervention for auditory processing difficulties are recommended. Tests suitable for use with younger children by audiologists in New Zealand ... include SCAN-3:C from 5 years of age and the ASA and CELF PreSchool 2 (User Level B) if below 5 years" (p. 52).
"Language therapy provided by a speech-language therapist may be warranted for many individuals diagnosed with [auditory processing disorder] APD. It is recommended that language therapy is provided to children with APD and language difficulties" (p. 76). Phonological processing therapy should be "provided to children with difficulties in this area" (p. 74). "Communication, metacognitive, metalinguistic, and compensatory interventions ... may be warranted for some children diagnosed with APD" (p. 77).
When assessing for auditory processing disorder (APD), "it is recommended that the following tests are included in audiometric assessment prior to APD testing: pure tone audiometry, word recognition in quiet, tympanometry, ipsilateral and contralateral acoustic reflexes, and distortion product otoacoustic emissions" (p. 35).
When screening for auditory processing disorder, "checklists of symptoms and comorbidities provide a simple and effective method of identifying children and adults who should be referred for diagnostic assessment .... Questionnaires can also be useful. Recommended questionnaires suitable for identification of children for referral in New Zealand are the TEAP, LIFE-7, APDQ, and ECLiPS" (p. 28).
<p>A multidisciplinary team is required for assessing and managing auditory processing disorders (APD) in children and adults.</p>
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<p>"As the professionals responsible for diagnosing APD and initiating treatment, it is recommended that audiologists take the lead role in APD case management" (p. 17). "Audiologists are the only professionals qualified to diagnose APD" (p. 51). Audiologists are also responsible for screening and direct treatment. <br /><br /></p>
<p>Speech-language therapists should provide input during pre-assessment evaluation and provide treatments related to accompanying language, phonological, or reading deficits.</p>
When assessing for auditory processing disorder, a behavioral test battery approach should be used to evaluate the following domains: auditory discrimination, dichotic listening, distorted speech, speech in noise, lateralization/localization, spatial segregation, temporal processing, pattern perception, auditory attention, and auditory memory.
When treating auditory processing disorder (APD), clinicians should provide information and support to individuals with APD and their families.
When assessing for auditory processing disorder, "comprehensive case history, pre-assessment questionnaires, reports of other relevant assessments, and direct observation can all be helpful in understanding a client’s hearing difficulties. Recommended pre-assessment questionnaires suitable for use in New Zealand include the TEAP, LIFE-7, APDQ, ECLiPS and SIFTER. The TEAP plus Question 1 of the SIFTER is recommended for routine use with children" (p. 29).
For treating auditory processing disorder (APD) in children, amplification with remote microphone hearing aid systems (RMHAs) is recommended. RMHAs should be used on a trial basis after fitting and verification by a qualified audiologist. Fittings and appropriateness of the device should be reviewed annually. Guidance on benefits and limitations and the care and use of RMHAs should be provided to teachers and families.
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<p>For treating APD in adults, amplification with conventional hearing aids or accessory remote microphones should be considered.</p>
<p>Amplified audiobooks using earphones and headphones should also be considered for treatment.</p>
"It is recommended that children with suspected or diagnosed language impairment, reading disorder, or dyslexia be referred for [auditory processing disorder] APD assessment and management" (p. 24). "Children with comorbidities, including other types of hearing disorders, can and should be assessed for APD by audiologists experienced in APD assessment" (p. 55). "In some cases APD assessments can be conducted in the presence of peripheral hearing loss by experienced audiologists. The information obtained may be limited but frequently some helpful information is obtained" (p. 56).
