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.
Background: Auditory processing disorder (APD) is a diagnosis that is widely discussed. Children diagnosed with APD have difficulty listening in complex situations, despite a well-functioning peripheral hearing. However, there seems to be no evidence for the validity of a purely auditory deficit. The aim of this study is to examine the differences in performance between children with suspected APD and typically developing children on tests of communication, auditory processing, nonverbal intelligence, working memory, and visual and auditory attention. Methods: In a case-control study we examined 9 children with suspected APD and 21 typically developing children, ages 8;0 to 12;0 years. The parents of all children completed three questionnaires about history, behavioral symptoms of ADHD, and communication skills. The teachers of the children completed the Children’s Auditory Processing Performance Scale (CHAPPS). The children themselves were assessed for auditory processing abilities, nonverbal intelligence, working memory, and auditory and visual attention. Results: No differences were found between groups in age, nonverbal intelligence quotient, and performance on auditory processing tests. Children with suspected APD have significantly poorer communication performance (parent report), poorer listening skills (teacher report), poorer working memory and poorer auditory and visual skills. Conclusion: There is a difference between children with suspected APD and typically developing children. Children with suspected APD perform insufficient on tests of working memory, and have a slower response to auditory and visual attention tasks. Parents of children with suspected APD report difficulties in communication and teachers assess the children of being at risk for listening difficulties.
Dit onderzoek is bedoeld om de huidige labelvorming van kinderen met luisterproblemen te onderzoeken en om in samenwerking met logopedisten en audiologen in Nederland te komen tot een uniforme en hanteerbare definitie en om de kennis en ervaring op het gebied van signalering, diagnostiek en behandeling te bundelen. De aanleiding voor dit promotieonderzoek zijn de vragen vanuit het werkveld (logopedisten, audiologen, psychologen AC) over AVP die tijdens presentaties op diverse congressen, in logopedische kwaliteitskringen en dyslexiekringen in de periode 2008-2012 en tijdens de studiedag “Diagnostiek van auditieve verwerkingsproblemen” van de FENAC op 21 mei 2014 (http://www.fenac.nl/algemeen/opleiding/studiedag-avp/studiedag-diagnostiek-van-auditieve-verwerkingsproblemen-avp.html) gesteld werden.
