A double-blind, placebo-controlled study was used to investigate the effects of methylphenidate (Ritalin) on tests of auditory processing in children diagnosed with both Attention Deficit Hyperactivity Disorder (ADHD) and Central Auditory Processing Disorder (CAPD). Thirty-two subjects received three Central Auditory Processing (CAP) tests and the Auditory Continuous Performance Test (ACPT), a measure of attention/impulsivity, at two separate test sessions: once when medicated with Ritalin and once when nonmedicated (placebo). Sixteen subjects were assigned randomly to receive their medication first and 16 to receive the placebo first. A counterbalanced 2 x 2 mixed factorial analysis of variance was conducted for each of the four dependent variables: Staggered Spondaic Word (SSW), Phonemic Synthesis (PS), Speech-in-Noise (SN), and ACPT measures. Analyses revealed that Ritalin did not have a significant effect on any of the three CAP measures. However, ACPT performance was significantly better (p < .000) for the Ritalin versus placebo condition.
For the past 10 years, Cacace and McFarland have contended that current central auditory processing tests are invalid because they cannot disassociate central auditory processing disorder (CAPD) from language, attention, and other problems. Over this period of time, they have not developed a battery of tests to compare with the current procedures, so the question cannot be resolved in a proper scientific fashion. Also, we disagree with their contention and demonstrate that an experienced audiologist, under double-blind research conditions, can reliably evaluate individuals with attention-deficit/hyperactivity disorder for CAPD, whether therapeutically controlled for attention with Ritalin or taking a placebo. Further, we show how intra- and intertest comparisons, as well as a team approach, disassociate CAPD from potential contamination from supramodal factors.
Children with Attention Deficit Hyperactivity Disorder (ADHD) manifest behaviors strikingly similar to children with Auditory Processing Disorders (APD). Recent research suggests that these two disorders are often co-morbid, but can occur independently. The appropriate management of ADHD and APD is dependent upon a reliable and valid diagnosis using multiple sources of information and measures. The most effective evidence based approaches for these two disorders are reviewed with an emphasis on the importance of differential diagnosis.Learning Outcomes: Upon completion of this article, the reader will understand (1) the assessment strategies and techniques that should be employed in order to accurately differentially diagnose ADHD and APD; (2) the lack of evidenced-based treatment approaches regarding the management of these two disorders; and (3) that ADHD and APD are two separate disorders, necessitating an interdisciplinary evaluation by both the audiologist and psychologist.orders, constitute a heterogeneous group with many co-morbid conditions, and present with strikingly similar symptoms of inattention, distractibility, hyperactivity, and poor listening skills. The appropriate management of a child necessitates accurate differential diagnosis.Children behave similarly for a variety of reasons and it is imperative that we remember that all that is hyper is not hyperactivity and all that is poor listening is not auditory processing dysfunction. Children with attention disorders, as well as children with auditory processing disDownloaded by: Wegner Health Science Information Center. Copyrighted material.
The results indicate that children with NVLD are at risk for APD and that there are several indicators on neuropsychological assessment suggestive of APD. Collaborative, interdisciplinary evaluation of children with learning disorders is needed in order to provide effective therapeutic interventions.
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