The impact of auditory processing and cognitive abilities in children

OBJECTIVES: To examine the links between auditory processing (AP) test results, functional deficits, and cognitive abilities.

DESIGN: One hundred and fifty-five children, ages 7-12 years, comprising 50 control children and 105 children referred for AP assessment, all with normal peripheral hearing, completed an AP and cognitive (sustained attention, auditory working memory, and nonverbal intelligence) test battery. Functional outcome measures of listening ability (developed using questionnaires from parent, teacher, and child respondents) and reading fluency were also collected.

RESULTS: AP scores for dichotic digits, frequency pattern, and listening in spatialized noise-sentences test baseline scores showed significant intertask correlations, and significant correlations with functional outcomes. The gaps in noise task showed correlation with reading fluency only. The AP tasks of masking level differences and spatial advantage showed no correlation with listening ability or reading fluency. Results showed significantly poorer cognitive abilities overall in the children referred for AP assessment compared with the control group. Within the referred group, children diagnosed with an auditory processing disorder had significantly poorer cognitive abilities than those passing the test battery. Correlation and regression studies showed significant associations between AP and cognitive scores. The results of multilinear regression analyses showed that the associations of AP scores with listening and academic results were no longer significant when cognitive scores were also included as predictors.

CONCLUSIONS: A complex interaction of cognitive abilities and AP scores is evident. For many children with listening difficulties, who perform poorly on AP tasks, cognitive deficits are also in place. Although the direction of causality is unclear, it is likely that these cognitive deficits are causing the perceived difficulty and/or are having a significant effect on the test results. Interpretation of AP tests requires consideration of how cognitive abilities may have impacted on not only task results but also the functional difficulties experienced by the child.