There is still no consensus about the nature of auditory processing disorders (APD). One of the most frequently reported symptoms for APD is difficulties with hearing and listening, especially in the presence of background noise, despite having normal peripheral hearing (ASHA, 2005; Jerger & Musiek, 2000). It is unclear whether there is a behavioral characteristic or whole set of symptoms that is solely attributable to problems with auditory processing. Such a distinctive feature could help audiologists and speech-language pathologists to differentiate APD from other developmental disorders. The purpose of this systematic review is to evaluate the literature on characteristics of children with suspected APD and to determine whether there is a distinctive feature.
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Purpose: The purpose of this letter is to respond to Moncrieff's (2017) letter to the editor, "Response to de Wit et al., 2016, 'Characteristics of Auditory Processing Disorders: A Systematic Review,'" published in May 2017 by the Journal of Speech, Language, and Hearing Research.Conclusion: We believe that our original conclusions are valid given the limited evidence that is currently available about the etiology of auditory processing disorders (APD). The focus of our systematic review was to identify the characteristics of children with a diagnosis of APD or a suspicion of APD. The results of our study showed that the characteristics of these children are not specific or limited to the auditory modality but are multimodal instead. In our view, it is incorrect to use the diagnosis APD, because there is not necessarily a specific auditory deficit in a large group of children suffering from listening difficulties. Before we start using any new diagnoses, a better insight into how bottom-up and top-down processes are precisely involved in listening needs to be developed. In addition, more insight is needed with respect to the similarities and differences between the different developmental disorders of children.
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OBJECTIVES: Children diagnosed with auditory processing disorders (APD) experience difficulties in auditory functioning and with memory, attention, language, and reading tasks. However, it is not clear whether the behavioral characteristics of these children are distinctive from the behavioral characteristics of children diagnosed with a different developmental disorder, such as specific language impairment (SLI), dyslexia, attention-deficit hyperactivity disorder (ADHD), learning disorder (LD), or autism spectrum disorder. This study describes the performance of children diagnosed with APD, SLI, dyslexia, ADHD, and LD to different outcome measurements. The aim of this study was to determine (1) which characteristics of APD overlap with the characteristics of children with SLI, dyslexia, ADHD, LD, or autism spectrum disorder; and (2) if there are characteristics that distinguish children diagnosed with APD from children diagnosed with other developmental disorders.DESIGN: A systematic review. Six electronic databases (Pubmed, CINAHL, Eric, PsychINFO, Communication & Mass Media Complete, and EMBASE) were searched to find peer-reviewed studies from 1954 to May 2015. The authors included studies reporting behaviors and performance of children with (suspected) APD and children diagnosed with a different developmental disorder (SLI, Dyslexia, ADHD, and LD). Two researchers identified and screened the studies independently. Methodological quality of the included studies was assessed with the American Speech-Language-Hearing Association's levels-of-evidence scheme.RESULTS: In total, 13 studies of which the methodological quality was moderate were included in this systematic review. In five studies, the performance of children diagnosed with APD was compared with the performance of children diagnosed with SLI: in two with children diagnosed with dyslexia, one with children diagnosed with ADHD, and in another one with children diagnosed with LD. Ten of the studies included children who met the criteria for more than one diagnosis. In four studies, there was a comparison made between the performances of children with comorbid disorders. There were no studies found in which the performance of children diagnosed with APD was compared with the performance of children diagnosed with autism spectrum disorder. Children diagnosed with APD broadly share the same characteristics as children diagnosed with other developmental disorders, with only minor differences between them. Differences were determined with the auditory and visual Duration Pattern Test, the Children's Auditory Processing Performance Scale questionnaire, and the subtests of the Listening in Spatialized Noise-Sentences test, in which noise is spatially separated from target sentences. However, these differences are not consistent between studies and are not found in comparison to all groups of children with other developmental disorders.CONCLUSIONS: Children diagnosed with APD perform equally to children diagnosed with SLI, dyslexia, ADHD, and LD on tests of intelligence, memory or attention, and language tests. Only small differences between groups were found for sensory and perceptual functioning tasks (auditory and visual). In addition, children diagnosed with dyslexia performed poorer in reading tasks compared with children diagnosed with APD. The result is possibly confounded by poor quality of the research studies and the low quality of the used outcome measures. More research with higher scientific rigor is required to better understand the differences and similarities in children with various neurodevelopmental disorders.
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Background: Children with difficulties in listening and understanding speech despite normal peripheral hearing, can be diagnosed with the diagnosis Auditory Processing Disorder (A). However, there are doubts about the validity of this diagnosis. The aim of this study was to examine the relation between the listening difficulties of children between 8 and 12 years with suspected A and the attention, working memory, nonverbal intelligence and communication abilities of these children.Material and methods: In this case-control study we examined 10 children who reported listening difficulties in spite of normal peripheral hearing (3 referred by speech-language pathologist in the Northern Netherlands, 6 by an audiological center in the Southern Netherlands and one by parental concern) and 21 typically developing children (recruitment through word of mouth and by the website Taalexpert.nl), ages 8;0 to 12;0 years. The parents of all children completed three questionnaires about history, behavioral symptoms of ADHD, and communication skills (Children’s Communication Checklist). Teachers of the children completed the Children’s Auditory Processing Performance Scale (CHAPPS). Children were assessed for auditory processing abilities (speech-in-noise, filtered speech, binaural fusion, dichotic listening), nonverbal intelligence (Raven’s Coloured Progressive Matrices), and working memory (Clinical Evaluation of Language Fundamentals). Auditory and visual attention was studied with four behavioral tests of the WAFF battery of the Vienna Test System (Schuhfried).Results: Preliminary analysis shows no differences between groups on the auditory processing tests and nonverbal intelligence quotient. Children in the experimental group have poorer communication performance (parent report), poorer listening skills (teacher report), and poorer working memory and attention skills (behavioral tests).Conclusions: The results of this study showed that there is a difference between children with listening complaints and typically developing children, but that the problems are not specific to the auditory modality. There seems to be no evidence for the validity of an auditory deficit.
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OBJECTIVE: This study investigated the perspectives of professionals from the Dutch audiological centres on the definition and care pathways of children with suspected auditory processing disorders (susAPD).DESIGN: focus group interviews.STUDY SAMPLE: In total, 45 professionals from 6 disciplines, representing 22 different audiological centres and one ambulatory service, participated in five parallel focus group interviews. Participants had a variety of experience in diagnosing and advising children with suspected APD.RESULTS: Qualitative analysis (open and thematic) identified four themes ("Definition", "Causes", "Diagnostic Procedures" and "Clinical Reasoning") expressing a variety of perspectives. Differences in perspectives were mainly affected by two debates: (1) whether or not APD exists as a pure (auditory) disorder and (2) whether or not current AP-tests are suitable in diagnosing children with listening difficulties. They also expressed a need for more guidance from the literature in their clinical decision making process.CONCLUSIONS: Professionals from the Dutch audiological centres share a broad perspective on children with APD. The ICF framework supports this perspective, thereby diminishing the need for a clear definition. The use of AP-tests should be limited to children where broader developmental disorders are first ruled out; a possible "pure" APD could then be diagnosed in a limited number of children.
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Kleding vormt de interface tussen het menselijk lichaam en de leefomgeving. Kleding geeft mensen de mogelijkheid om hun identiteit en culturele achtergrond uit te drukken. Daarnaast heeft kleding vaak een beschermende rol, vooral tegen extreme weersomstandigheden zoals hoge en lage temperatuur, neerslag, wind, zonnestraling, maar ook tegen vuil, gifgas, kogels (zogenaamde ballistische bescherming), stoten, extreme druk, explosies e.d. Soms is kleding juist nodig om de omgeving af te schermen tegen vuil dat de mens produceert, zoals bij de productie van computerelektronica. Onder kleding wordt in deze verhandeling al het materiaal verstaan dat het menselijk lichaam omhult. Globaal betreft het voor het hoofd een hoofddeksel, voor de handen handschoenen of wanten, voor de voeten sokken en schoenen. Voor het boven- en onderlijf is meer keuze beschikbaar zoals een hemd, bh, Tshirt, polo, overhemd, trui, jas, onderbroek, broek en rok. Er zijn ook kledingstukken die boven- en onderlijf omspannen zoals een jurk, overall en lange jas. Bovendien is er een grote variatie binnen een categorie kledingstukken; hierbij kan onderscheid gemaakt worden in vorm, materiaal en kleur. In het lectoraat is gekozen voor drie speerpunten van onderzoek voor kleding/mode. Deze speerpunten zijn tot stand gekomen op basis van aanwezige expertise in de kenniskring van het lectoraat, analyse van kennislacunes en een inschatting van potentieel relevante maatschappelijke ontwikkelingen.
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De toeristisch-recreatieve sector is in belangrijke mate afhankelijk van externe factoren waar zij zelf geen invloed op kan uitoefenen maar wel mee geconfronteerd wordt. Het kan hier bijvoorbeeld gaan om bevolkingskrimp, vergrijzing, ontgroening, technologische ontwikkelingen, de economische recessie, de veranderende interesses van toeristen e.d. Door deze externe factoren te analyseren ontstaat er zicht op relevante bewegingen die de sector een toekomstbestendige koers bieden. Er is de behoefte ontstaan om nader onderzoek te doen naar de innovatiekracht van Overijssel in totaliteit en gekoppeld aan de regio’s die vanuit marketing perspectief zijn benoemd te weten: • Waterrijk Weerribben Wieden: ongerept en eigenzinnig. • IJsseldelta: Hanzesteden, water, cultuur, polder. • Vechtdal Overijssel: rust en ruimte. • Salland: natuurlijk gastvrij. • Twente: Landgoed van Nederland. Het European Tourism Futures Institute is gevraagd dit onderzoek uit te voeren met behulp van een scenariostudie. Scenario’s verkleinen de afstand tot de dynamische markt en leveren inspiratie om innovatieve initiatieven te ontplooien. Scenario’s zoals die door het ETFI worden ontwikkeld zijn geen voorspellingen die voortkomen uit trendanalyses, maar levendige beschrijvingen van hoe de toekomst, in dit geval van toeristisch Overijssel, er uit zou kunnen zien.
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