Practical guidelines to minimise language and cognitive confounds in the diagnosis of CAPD: a brief tutorial

Abstract

Differential diagnosis is exceedingly important and can be quite challenging. Distinguishing between two or more conditions presenting with similar symptoms or attributes requires multidisciplinary, comprehensive assessment. To ensure appropriate interventions, the audiologist is a member of the multidisciplinary team responsible for determining whether there is an auditory component to other presenting deficits or whether one condition is responsible for the symptoms seen in another. Choice of tests should be guided both by the symptoms of the affected individual, as established in an in-depth interview and case history, the individual's age and primary language, and by the specific deficits reported to be associated with specific clinical presentations. Knowing which tests are available, their strengths and limitations, the processes assessed, task and response requirements, and the areas of the central auditory nervous system (CANS) to which each test is most sensitive provides the audiologist with critical information to assist in the differential diagnostic process.

Response to the Letter to the Editor From Moncrieff (2017) Regarding de Wit et al. (2016), “Characteristics of Auditory Processing Disorders: A Systematic Review”

“…This is also why we recommended multidisciplinary evaluation of listening difficulties, including an audiologist, speech-language pathologist, and behavioral scientist. The audiologist is responsible for determining whether there is an auditory component that can explain the listening difficulties and has to minimize confusing cognitive and language-processing variables during testing (Chermak, Bamiou, Iliadou, & Musiek, 2017).…”

Auditive Verarbeitung und Wahrnehmung bei Jugendlichen mit Kommunikationsbeeinträchtigungen

“…Andererseits ist auch in der Leitlinie der DGPP 34 ausführlich beschrieben, dass bei Kindern die wichtigsten Differenzialdiagnosen (Sprachverständnisstörungen, Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen, kognitive Störungen und Lese-Rechtschreib-Störungen) hinreichend zu berücksichtigen sind. Es wurde schon verschiedentlich diskutiert, dass es bei Testverfahren zur Erfassung zentral-auditiver Prozesse durch sprachliche und kognitive Effekte zu Verzerrungen oder Verfälschungen der Ergebnisse kommen kann 35 36 .…”

A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus

“…Test results interpretation is facilitated by carefully evaluating an individual’s behavior as measured by specific questionnaires ( 51 ) and detailed clinical interview during history taking that includes an audiological history (of auditory symptoms, early development of auditory behaviors, and APD risk factors including a family history of APD as well as of HL). When choosing the auditory processing tests, language and cognitive confounds should be minimized ( 52 ). In this respect, a detailed receptive and expressive language evaluation may in some cases be necessary to choose those language-based audiologic tests which are appropriate regarding the individual’s language development, and, second, to identify language development impairments as possibly higher level disorder which may impact audiological results.…”