title: Nature of auditory processing disorder in children.
abstract: OBJECTIVE
  We tested the specific hypothesis that the presentation of auditory processing disorder (APD) is related to a sensory processing deficit.
  
  
  METHODS
  Randomly chosen, 6- to 11-year-old children with normal hearing (N = 1469) were tested in schools in 4 regional centers across the United Kingdom. Caregivers completed questionnaires regarding their participating children's listening and communication skills. Children completed a battery of audiometric, auditory processing (AP), speech-in-noise, cognitive (IQ, memory, language, and literacy), and attention (auditory and visual) tests. AP measures separated the sensory and nonsensory contributions to spectral and temporal perception.
  
  
  RESULTS
  AP improved with age. Poor-for-age AP was significantly related to poor cognitive, communication, and speech-in-noise performance (P < .001). However, sensory elements of perception were only weakly related to those performance measures (r < 0.1), and correlations between auditory perception and cognitive scores were generally low (r = 0.1-0.3). Multivariate regression analysis showed that response variability in the AP tests, reflecting attention, and cognitive scores were the best predictors of listening, communication, and speech-in-noise skills.
  
  
  CONCLUSIONS
  Presenting symptoms of APD were largely unrelated to auditory sensory processing. Response variability and cognitive performance were the best predictors of poor communication and listening. We suggest that APD is primarily an attention problem and that clinical diagnosis and management, as well as further research, should be based on that premise.
authors.affiliation: Medical Research Council Institute of Hearing Research, Nottingham, UK. davem@ihr.mrc.ac.uk
authors.forename: David R
authors.initials: DR
authors.lastname: Moore
authors.forename: Melanie A
authors.initials: MA
authors.lastname: Ferguson
authors.forename: A Mark
authors.initials: AM
authors.lastname: Edmondson-Jones
authors.forename: Sonia
authors.initials: S
authors.lastname: Ratib
authors.forename: Alison
authors.initials: A
authors.lastname: Riley
mesh_terms: D001288:Attention; D001308:Auditory Perceptual Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003147:Communication Disorders / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D009483:Neuropsychological Tests; D009622:Noise / Q000009:adverse effects; D015588:Observer Variation; D012720:Severity of Illness Index; D013067:Speech Perception; D011795:Surveys and Questionnaires; D013998:Time Perception; D014796:Visual Perception