Comorbidity of auditory processing, language, and reading disorders

Purpose: The authors assessed comorbidity of auditory processing disorder (APD), language impairment ( LI), and reading disorder (RD) in school-age children. Method: Children (N = 68) with suspected APD and nonverbal IQ standard scores of 80 or more were assessed using auditory, language, reading, attention, and memory measures. Auditory processing tests included the Frequency Pattern Test ( FPT; F. E. Musiek, 1994; D. Noffsinger, R. H. Wilson, & F. E. Musiek, 1994); the Dichotic Digit Test Version 2 (DDT; F. E. Musiek, 1983); the Random Gap Detection Test (R. W. Keith, 2000); the 500-Hz tone Masking Level Difference (V. Aithal, A. Yonovitz, & S. Aithal, 2006); and a monaural low-redundancy speech test (compressed and reverberant words; A. Boothroyd & S. Nittrouer, 1988). The Clinical Evaluation of Language Fundamentals, Fourth Edition (E. Semel, E. Wiig, & W. Secord, 2003) was used to assess language abilities (including auditory memory). Reading accuracy and fluency and phonological awareness abilities were assessed using the Wheldall Assessment of Reading Passages (A. Madelaine & K. Wheldall, 2002) and the Queensland University Inventory of Literacy (B. Dodd, A. Holm, M. Orelemans, & M. McCormick, 1996). Attention was measured using the Integrated Visual and Auditory Continuous Performance Test (J. A. Sandford & A. Turner, 1995). Results: Of the children, 72% had APD on the basis of these test results. Most of these children (25%) had difficulty with the FPT bilaterally. A further 22% had difficulty with the FPT bilaterally and had right ear deficits for the DDT. About half of the children (47%) had problems in all 3 areas (APD, LI, and RD); these children had the poorest FPT scores. More had APD-RD, or APD-LI, than APD, RD, or LI alone. There were modest correlations between FPT scores and attention and memory, and between DDT scores and memory. Conclusions: LI and RD commonly co-occur with APD. Attention and memory are linked to performance on some auditory processing tasks but only explain a small amount of the variance in scores. Comprehensive assessment across a range of areas is required to characterize the difficulties experienced by children with APD.