Many different types of disorders fall within the ambit of CAPD; therefore testing can include a variety of tests. Not all tests have been found to directly relate to listening difficulty or academic performance and results can be affected by other problems. Fatigue is also a problem in some testing methods, as exhaustive test batteries can lead to unreliable results.
At Pristine Hearing, our test battery includes those that measure deficits proven to relate to listening difficulties and/or poor academic performance. Pristine Hearing takes a hierarchical approach to assessing CAPD; in a strategic method, only necessary tests are performed, considering previous results already obtained. Before any CAPD assessment occurs, Pristine Hearing will conduct a thorough hearing assessment (including micro-suction earwax removal) on your child to ensure there is no peripheral hearing loss. We perform CAPD assessment where there is no hearing loss identified and the child is at least 6 years old.
Our testing process involves:
- Spatial Processing Disorder Assessment
Spatial Processing Disorder is a type of CAPD that makes it difficult to use directional cues within sounds that we need to be able to separate background noise from the sound we want to hear. For instance, focusing on a teacher speaking in a classroom over the noise of students. If your child is struggling to hear in the presence of background noise, then they may have Spatial Processing Disorder. Pristine Hearing offers the LISN-S test, developed by the National Acoustics Laboratory (NAL) to assess speech understanding in the presence of background noise. The good news is that children with SPD can undergo remediation by participating in a 10-week auditory training program developed by NAL in the form of a fun and interactive game called Sound Storm played on an iPad.
Research has shown that when children with SPD play this fun and interactive game twice a day (20 minutes per session), 5 days a week for 10 weeks, 90% of children will be able to improve their ability to hear background noise such that they will be able to perform as well as they once did but with 10dB more noise. This amazing result and performance have been shown to extend beyond the end of the training period and be maintained long-term. For more information, please visit the NAL website.
- Short-Term and Working Auditory Memory Testing
Short-term memory deficits have been linked to poor academic performance and increased reports of listening difficulties. Where SPD is not the cause of your child’s problem, poor working and short-term auditory memory could be creating listening difficulties in the classroom. After the LISN-S test, your Audiologist may proceed with an auditory short-term memory and auditory working memory assessment. This is measured using Number Memory Forward (NMF) which is a sub-test of the Test of Auditory Processing Skills – Third Edition (TAPS). This test was designed to assess how well a child can retain simple sequences of auditory information. Likewise, Auditory Working Memory has been linked with listening difficulties, academic problems and even listening fatigue.
To assess this, the TAP-developed, Number Memory Reverse (NMR) is used. If a short-term memory deficit is identified, a remedial development program will be recommended. If not, additional tests will be required. Children with auditory memory deficits can improve their skills with a course of auditory training and memory skills development. Pristine Hearing recommends the software package Memory Booster, an interactive game played on the computer 3 times a week over 8 weeks. With different degrees of difficulty designed to push your child to develop different strategies that can improve their auditory memory skills, it has shown improvement in around 60% of children. For more information about Memory Booster, visit Dichotic Digits – Binaural Integration
- Amblyaudia or Dichotic Dysaudia Assessment
Lastly, if no SPD or memory deficits have been identified, your Audiologist will perform the Random Dichotic Digits Test (RDDT) and the Dichotic Word Test (DWT) to determine if your child has the auditory processing disorder known as Amblyaudia or Dichotic Dysaudia. Amblyaudia occurs when there is a significant asymmetry between how well each ear performs at binaural integration activities.
Dichotic Dysaudia occurs when both ears are weak at transferring auditory information to the correct brain hemisphere. A child with either of these deficits will struggle to hear in a noisy classroom and will generally have poorer attention than their peers. If a binaural integration deficit is found (either Dichotic Dysaudia or Amblyaudia), research has shown that using the auditory training methodology called Auditory Rehabilitation for Interaural Asymmetry (ARIA), a child or even an adult can be rehabilitated.
Pristine Hearing is the only accredited WA service provider of the binaural integration auditory training package CAPDOTS. Visit the CAPDOTS website for more information. To learn more about ARIA and Amblyaudia, here are some articles by leading researcher, Assistant Professor Deborah Moncrieff:
Diagnosis of Amblyaudia in Children
Evidence of Binaural Integration Benefits Following ARIA Training for Children
