No abstract

We need to rethink how we assess auditory processing disorder (APD). The current use of test batteries, while necessary and well accepted, is at risk of failing as the size of these batteries increases. To counter the statistical, fatigue, and clinical efficiency problems of large test batteries, we propose a hierarchical approach to APD assessment. This begins with an overall test of listening difficulty in which performance is measurably affected for anyone with an impaired ability to understand speech in difficult listening conditions. It proceeds with a master test battery containing a small number of single tests, each of which assesses a different group of skills necessary for understanding speech in difficult listening conditions. It ends with a detailed test battery, where the individual tests administered from this battery are only those that differentiate the skills assessed by the failed test(s) from the master test battery, so that the specific form of APD can be diagnosed. An example of how hierarchical interpretation of test results could be performed is illustrated using the Listening in Spatialized Noise-Sentences test (LiSN-S). Although consideration of what abilities fall within the realm of auditory processing should remain an important issue for research, we argue that patients will be best served by focusing on whether they have difficulty understanding speech, identifying the specific characteristics of this difficulty, and specifically remediating and/or managing those characteristics.

The CHAPS, SIFTER, and TAPS-R should be used to highlight concerns about a child but not to determine whether a diagnostic (C)AP assessment is particularly warranted.

The use of standardised patients (SPs) and computer based simulations (CBSs) has been suggested as a method of providing students in the health sciences with basic clinical skills without relying on extensive support from external clinics. This study used a questionnaire to determine if 25 first-year audiology students from an audiology program in a large Australian university felt their interactions with SPs and CBSs had improved their ability to interact with clients and perform a basic audiometric assessment. These students reported their interactions with the SPs significantly (p < .01) improved their performance in 10 out of 10 areas of client interaction and their interactions with the CBS significantly (p < .01) improved their abilities in 6 out of 8 areas of basic audiometry. They also reported that the SPs' portrayals of the cases and the content of the simulated cases were realistic, although further preparation for interacting with the SPs was desirable. Overall, these results support the continued investigation of SPs and CBSs as potential methods of training and assessing Australian audiology students in the areas of client interaction and basic audiometry.