Communication Disorders Quarterly

The processing of auditory information is a complex task that involves a variety of peceptual and conceptual processes. The process begins with the sensation of an auditory signal and successfully when the appropriate meaning is assigned to the signal. In this articles we will demonstrate how professional and theoretic perspectives significantly influence the manner in which CAP is viewed, assessed, and remediated.

The identification and assessment of children with possible auditory disorders present the speech language pathologist with a set of problems that are quite familiar. The problems revolve around a set of decisions regarding what testing is necessary, what is "merely" interesting, and what testing may lead to new information. Certain testing is required in order to rule out or document that a problem exists, to determine, the type and magnitude of the problem, and to establish a meaningful basis for recommending intervention. Other test approaches may be interesting and lead to a better understanding of the child's problem, although they may not be critical to the determination of remediation approaches. And finally, some test approaches may lead to unexpected new in formation about the child. The purpose of this articles is to provide specific information about the authors views of the interdisciplinary team approach to this problem. Each of the members of this team has a different responsability in the identification, assessment and remediation of children with auditory processing disorders. We will try to define those roles in this article.

Central auditory processing (CAP) disordered language impaired (LI) children have listening, language and learning difficulties that come to the attention of both the audiologist and the speech-language pathologist. Traditionally, the former has been resposible primarly for CAP diagnosis and the latter has been assigned the task of remediation. In this article, the contributions of both professionals to the diagnosis and management of this population are discussed. The variables that can compound the evaluative and therapeutic efforts of audiologists and speech-language pathologists are examined and used to show that shared professional perspectives are the most efficacious ones.

This article will profile five interesting cases of children with learning disabilities and auditory processing problems. These children have met a rather stringent criteria in terms of being classified as learning disabled. All subjects had normal peripheral hearning and speech discrimination ability in quiet bilaterally, with the exeption of Case 2. Each received extensive educational, psychological, and speech and language evaluations in addition to our audiological work-up. However, we will focus only on the audiological evaluations. Following each case, we will discuss the possible correlations between the presumed etiology and the unique audiological pattern on the central test battery. These five cases represent various kinds of central auditory profiles, with associated etiological correlates, which provide a categorization system for these children.

It is not surprisingly that most books and articles dealing with Central Auditory Processing (CAP) disorders place heavy emphasis on the diagnosis of the problem and its associated disabilities, with little mention of habilitation. In the natural course of events it is first necessary to know that a problem exists, what its impact may be, and how it can be identified before venturing to remediate it. To date, considerable research and clinical effort has been expended to better understand the problems and to identify the children who are impaired. A wide variety of procedures has also been used to measure CAP disabilites. It would follow that emphasis should now be directed toward what can be done to improve a child's ability to perform at school and home whne auditory difficulties are uncovered.

The previous articles of this special issue have provided insight on various perspectives of Central Auditory Processing (CAP) evaluation and remediation. We hope to further broaden the reader's knowledge and interest in CAP disorders in children by identyfying unresolved issues and research needs. The issues and needs are an outgrowth or the previous sections in this publication, our search of the literature, and our own involvement in the quagmire that has become CAP disorders in children. Areas which will be discussed in this section are: (1) Early identification through screening; (2) Relationship between test battery results and auditory behaviors; (3) Relationship between test battery results and therapy planning, and (4). New assessment procedures.