title: Behavioral assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate.
abstract: OBJECTIVE
  Peripheral hearing disorders have been frequently described in children with non-syndromic cleft lip and/or palate (NSCL/P). However, auditory processing problems are rarely considered for children with NSCL/P despite their poor academic performance in general compared to their craniofacially normal peers. This study aimed to compare auditory processing skills, using behavioral assessment techniques, in school age children with and without NSCL/P.
  
  
  METHODS
  One hundred and forty one Mandarin-speaking children with NSCL/P aged from 6.00 to 15.67 years, and 60 age-matched, craniofacially normal children, were recruited. Standard hearing health tests were conducted to evaluate peripheral hearing. Behavioral auditory processing assessment included adaptive tests of temporal resolution (ATTR), and the Mandarin pediatric lexical tone and disyllabic-word picture identification test in noise (MAPPID-N).
  
  
  RESULTS
  Age effects were found in children with cleft disorder but not in the control group for gap detection thresholds with ATTR narrow band noise in the across-channel stimuli condition, with a significant difference in test performance between the 6 to 8 year group and 12 to 15 year group of children with NSCL/P. For MAPPID-N, the bilateral cleft lip and palate subgroup showed significantly poorer SNR-50% scores than the control group in the condition where speech was spatially separated from noise. Also, the cleft palate participants showed a significantly smaller spatial separation advantage for speech recognition in noise compared to the control group children.
  
  
  CONCLUSIONS
  ATTR gap detection test results indicated that maturation for temporal resolution abilities was not achieved in children with NSCL/P until approximately 8 years of age compared to approximately 6 years for craniofacially normal children. For speech recognition in noisy environments, poorer abilities to use timing and intensity cues were found in children with cleft palate and children with bilateral cleft lip and palate compared to craniofacially normal children. Consequently, it is worthwhile to consider the potential for auditory processing disorder in when assessing the auditory status of children with NSCL/P.
authors.affiliation: Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, China. Electronic address: xiaoran@connect.hku.hk.
authors.forename: Xiaoran
authors.initials: X
authors.lastname: Ma
authors.affiliation: Division of Speech and Hearing Sciences, Faculty of Education, The University of Hong Kong, Hong Kong, China.
authors.forename: Bradley
authors.initials: B
authors.lastname: McPherson
authors.affiliation: School of Stomatology, Beijing University, Beijing, China.
authors.forename: Lian
authors.initials: L
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001299:Audiometry; D001308:Auditory Perceptual Disorders / Q000175:diagnosis*; D016022:Case-Control Studies; D002648:Child; D002971:Cleft Lip / Q000150:complications*; D002972:Cleft Palate / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D013067:Speech Perception
keywords: Auditory processing disorder; Cleft lip and/or palate; Gap detection test; Hearing in noise; Mandarin-speaking; School children