New Zealand Guidelines on Auditory Processing Disorder

Abstract

These Guidelines are intended to provide guidance to clinicians, public agencies, the wider community of professionals who need to know about auditory processing disorder (APD), and people with APD and their families. APD is a generic term for hearing disorders that result from atypical processing of auditory information in the brain. APD results in persistent limitations in the performance of auditory activities with resultant significant consequences for participation. The symptoms of APD bear many similarities to other types of hearing disorder, but APD differs in that it is not detected by standard audiometric assessments. The overall prevalence in children in New Zealand (NZ) is estimated at 6.2%, with higher rates in some populations, particularly the elderly. APD affects academic achievement, participation, career opportunities and psychosocial development. APD should be suspected when there are reports of poor hearing and auditory comprehension in some circumstances despite normal pure tone hearing test results. Checklists of symptoms and comorbidities provide a simple and effective method of identifying children and adults who should be referred for diagnostic assessment. APD frequently co-occurs with other learning or developmental disabilities. It is recommended that children with dyslexia, language disorder, disorders affecting the brain, significant history of middle ear disease, autism spectrum disorder and reading difficulties are referred for APD assessment. Referral is also recommended for children with attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD) if listening concerns persist after treatment. A diagnosis of APD is made by an audiologist using specific audiological tests. Although evidence of APD can sometimes be observed in electrophysiological studies and confirmation of APD is being investigated using imaging studies, behavioural tests are typically used for diagnosis. Tests suitable for use in New Zealand are recommended in the Guidelines. Recommended diagnostic criteria are also presented.