The audiologist is the key player in the diagnosis of (Central) Auditory Processing Disorder (C)APD. Actually, an audiologist is the only professional that can make a diagnosis of (C)APD, and if someone tells you differently, that is incorrect. There is a lot of awareness of (C)APD right now, and there is a lot of information available about this disorder; some is correct, some isn’t. As a parent, you are charged with sorting through the volumes of information and making an informed decision about seeking an auditory processing evaluation for your child. This blog is intended to summarize the roles of different players in the diagnostic process.

The Team

Professionals from several disciplines may be on an auditory processing diagnostic team. When diagnosing (C)APD, the audiologist, a speech-language pathologist, and a psychologist or neuropsychologist will likely form the diagnostic team. Each team member has a very specific role.

The actual definition of auditory processing disorder dictates that hearing, language, and intellectual or learning ability must be at least average, so these areas must be tested before the auditory skills evaluation. This ensures that your child's problems are not the result of a deficit in a different area. A speech-language pathologist will evaluate oral and/or written language skills, and a psychologist will probably be asked to evaluate behavioral and/or cognitive areas. If the results of the language and psychological evaluations are normal or average, the audiologist will conduct the auditory processing testing. What this means is that the audiologist, who actually makes a (C)APD diagnosis, will probably be the last team member to evaluate your child.

You or your child's physician may start a referral for testing with a speech-language pathologist, a psychologist, or an audiologist; any of these is a good starting point. The important thing is to be sure that the professional you choose is knowledgeable about auditory processing, understands the diagnostic process, and will facilitate the flow of information among the team.

The Role of the Speech Therapist

As mentioned, the definition of (C)APD requires that other deficits or disorders be ruled out before a diagnosis of auditory processing disorder can be considered. Language processing disorder is one of the things that must be confirmed or ruled out, so a speech-language pathologist is usually the first professional to evaluate a child for potential auditory processing disorder.

The role of the speech-language pathologist is to diagnose the language processing abilities of your child. Remember that auditory processing and language processing are not the same thing. The audiologist depends on the assessment of the speech-language pathologist to be certain that a child’s responses reflect auditory difficulties, not inability to understand or express language. A language processing evaluation will certainly include the verbal areas, listening and speaking, and may also include the written language areas of reading and writing. The language evaluation will determine that your child does or does not have adequate language understanding and language expression skills.

If the language processing evaluation confirms your child has language skills within normal ranges, your speech-language pathologist also may screen for auditory processing. A speech-language pathologist can’t diagnose (C)APD, but can screen for the potential for (C)APD. There are several diagnostic tools that are available to speech-language pathologists that provide screening-level evaluation of a variety of auditory skills that may indicate the presence or probability of auditory processing disorder. The results of the screening are shared with the audiologist, who will integrate the screening data into the audiological evaluation as appropriate and make the final diagnosis. As a speech-language pathologist, I think being such an important part of the diagnostic process is so cool!

The Role of the Psychologist

It may be appropriate for a psychologist or neuropsychologist to be involved in the diagnosis of auditory processing disorder by ruling out the presence of other behavioral disorders, such as ADHD, or intellectual deficits. These disorders share many common symptoms with auditory and language processing disorders, so a psychological evaluation may be necessary to ensure that the final diagnosis is accurate. The referral to psychology may be made by any member of the diagnostic team. As with the results of the language processing evaluation, the results of the psychological evaluation are forwarded to the audiologist who integrates the information into the final diagnosis.

The Role of the Audiologist

An audiologist’s first step is to check your child's hearing. As we said earlier, a child has to have normal hearing before a diagnosis of auditory processing can be considered. After it is confirmed that your child's hearing is normal, the audiologist will determine additional tests that will be used for the auditory processing testing. The auditory testing will probably take place in a sound-controlled testing booth.

The audiologist is the professional who will determine the tests to be given. For example, the testing might require your child to listen and respond to a message when there is background noise or to listen and respond to different messages in each ear at the same time. The audiologist will go over the selected tests beforehand, so that you will understand what is being tested and why.

The goal of the audiological evaluation is, of course, to determine whether or not an auditory processing disorder is present. If skills are identified as deficient and a diagnosis of auditory processing is given, the test information will allow the audiologist to develop specific strategies to help your child manage the disorder.

Postscript
Parents come to me and say, for example, “I think my child has auditory processing problems.” Or, “Somebody told me it might be auditory processing.” Determining auditory processing disorder is complex and time-consuming. While the process isn’t convenient, it’s important and essential to get the diagnosis right. As always, you want what's best or your child, and the correct diagnosis is the gateway to answers and solutions.

Contact me at 940-704-4324 for more information.