Question
I work in the public school setting. Testing instruments are limited! How can I effectively assess for CAPD? What tests should I administer?
Answer
This is not an easy question to answer, as there is no one test battery that is appropriate for all APD assessments. First, it is important that test measures are selected that have demonstrated sensitivity and specificity for disorders of the central auditory nervous system (CANS) and that they are administered and interpreted in a manner consistent with the research for each test. That means that you'll need to do a great deal of independent research selecting the components of your test batteries and becoming familiar with each test. Second, you will want to tap into a variety of processes and levels within the CANS, which will require the use of several tests. The selection of which tests that should be included in a battery should be complaint-driven, not test-driven, which means that there is no one test battery that is appropriate for all children. Finally, keep in mind that children under the age of 7 or 8 cannot be validly evaluated for APD using behavioral methods, and there are a number of other ''rules'' governing assessment in the school-aged population, as well.
With that having been said, you will probably want at least two dichotic measures (one that assesses Binaural Separation and one that assesses Binaural Integration), a test of temporal patterning (such as Duration and/or Frequency Patterns), a test of monaural separation/auditory closure (such as filtered speech, time-compressed speech, etc.), a test of other temporal processing (e.g., gap detection, auditory fusion, etc.), measures of auditory discrimination, and perhaps measures of localization/lateralization and other auditory behaviors. Current recommendations suggest that both speech and nonspeech stimuli should be used in the overall evaluation, and many appropriate tests may be found on the Tonal and Speech Materials for Auditory Perceptual Assessment, disc 2.0 c.d. available from the VA Hospital in Mountain Home, TN. Again, though, it is absolutely critical that you carefully evaluate each and every test and understand the neuroscience bases, appropriate methods of administration and interpretation, normative data, and other principles before entering into APD assessment. Although these tests are easily obtained and not too difficult to score, accurate selection, administration, and interpretation of these tests do require a great deal of additional education and training not typically found in the audiologist's professional education. There are several textbooks and articles on the subject that you should review before beginning any APD assessment program.
Dr. Teri James Bellis is the author of Assessment and Management of Central Auditory Processing Disorders in the Educational Setting: From Science to Practice (2nd edition) and When the Brain Can't Hear: Unraveling the Mystery of Auditory Processing Disorder. She is an associate professor of audiology at the University of South Dakota.
