Survey of care pathway for auditory processing disorder

Abstract

In October 2003, the British Society of Audiology instigated the development of a Special Interest Group to study auditory processing disorder (APD) in the UK, and a steering committee was appointed. There is limited epidemiological information on APD, mainly because there is no general agreement on diagnostic markers. This is exacerbated by the potential overlap between the symptomatology of APD and other developmental conditions that impact on differential diagnosis. Children are referred for and receive clinical labels of APD but no clear evidence existed of service provision for those identified with APD in the UK. The APD Steering Committee aimed to check the Care Pathway for children currently identified with, or suspected of having, APD. A short questionnaire was developed which comprised 25 items. The questions addressed care pathway issues from screening and referral route, through diagnosis and management. The questionnaire was sent via email to practitioners in audiology (n 0/ 407) and speech language therapy, SLT (n 0/ 350) for whom an email address was available from datasets easily accessible to the steering committee. There was an overall response rate of 46% with only a minimal response from respondents who provide services only for adults. Hence this article reports on the survey outcomes for paediatric services only. Comparison with the number of paediatric hearing services trained by the Modernising Children's Hearing Aid Services (MCHAS) team and the identified geographical coverage over England, suggests these data can be generalized across England for audiology services but not for SLT. Only a small percentage of respondents provide a screen (9.6%) or diagnostic (11.1%) service for this condition. Over half the respondents report being at best 'not well' informed about APD. Perhaps the most interesting finding is that only a minimal number of respondents who offer to diagnose APD consider they are 'very well informed' about the condition. This raises a question on the confidence of diagnoses provided by such services.

Services for Children With Central Auditory Processing Disorder in the Republic of Ireland: Current and Future Service Provision

“…It would also be useful to ascertain if and how (C)APD is currently taught in relevant undergraduate or postgraduate education programs. The participants in the current study reported that they were frustrated about lack of knowledge and training in this area and they were attempting to address this gap through self-directed reading, attendance at training events, and discussing (C)APD with other professionals.With regard to screening and diagnostic services, the findings of this study are similar to Hind (2006) in that the majority of participants neither screen nor diagnose (C)APD. In this study, only 3% of the participants reported that they diagnosed (C)APD and all were SLTs (n = 6).…”

“…More than 50% of the respondents rated themselves as being not very well informed about this condition. Of interest, Hind (2006) found that a minimal number of the respondents who reported that they diagnosed APD considered they were very well informed about the condition.Service provision for children with speech, language, communication, hearing and listening needs differs from country to country (e.g., depending on the entry-level qualifications of professionals, governmental funding, structure and organization of services, and population size). The professionals who would be involved in the management of children with (C)APD in Ireland are speech and language therapists, audiological scientists and educational psychologists.…”

“…These guidelines provide evidence-based recommendations for the diagnosis, treatment and management of children and adults with (C)APD. The AAA (2010) states that (C)APD refers to difficulties in the perceptual processing of auditory information in the central nervous system and the neurobiological activity that underlies that processing.There have been a number of studies that have investigated professionals' preparation for assessment, diagnosis and management of (C)APD (Chermak, Silva, Nye, Hasbrouch & Musiek, 2007;Chermak, Traynham, Seikel & Musiek, 1998;Hind, 2006). In the United States (US), Chermak et al (1998) investigated professional preparation for assessment and diagnosis of (C)APD among audiologists.…”

“…The results of this study suggested that there was an improvement in the academic preparation of audiologists in (C)APD. However, they found little change in clinical preparation and the use of an efficient central auditory assessment battery.In the United Kingdom (UK), Hind (2006) reported on a study that investigated the care pathway for children and adults with suspected or identified auditory processing disorder (APD). This research was conducted by the Steering Committee of APD UK that had been established by the British Society of Audiology (BSA) in 2003.…”

Auditory Processing Disorders with and without Central Auditory Discrimination Deficits

“…(BSA 2011). Explicitly referring to "nonspeech sounds" emphasizes the difference to linguistic processing (Hind 2006). The BSA further points out "… poor perception of speech alone is not sufficient evidence of APD."…”