No abstract

We need to rethink how we assess auditory processing disorder (APD). The current use of test batteries, while necessary and well accepted, is at risk of failing as the size of these batteries increases. To counter the statistical, fatigue, and clinical efficiency problems of large test batteries, we propose a hierarchical approach to APD assessment. This begins with an overall test of listening difficulty in which performance is measurably affected for anyone with an impaired ability to understand speech in difficult listening conditions. It proceeds with a master test battery containing a small number of single tests, each of which assesses a different group of skills necessary for understanding speech in difficult listening conditions. It ends with a detailed test battery, where the individual tests administered from this battery are only those that differentiate the skills assessed by the failed test(s) from the master test battery, so that the specific form of APD can be diagnosed. An example of how hierarchical interpretation of test results could be performed is illustrated using the Listening in Spatialized Noise-Sentences test (LiSN-S). Although consideration of what abilities fall within the realm of auditory processing should remain an important issue for research, we argue that patients will be best served by focusing on whether they have difficulty understanding speech, identifying the specific characteristics of this difficulty, and specifically remediating and/or managing those characteristics.

The CHAPS, SIFTER, and TAPS-R should be used to highlight concerns about a child but not to determine whether a diagnostic (C)AP assessment is particularly warranted.

The use of standardised patients (SPs) and computer based simulations (CBSs) has been suggested as a method of providing students in the health sciences with basic clinical skills without relying on extensive support from external clinics. This study used a questionnaire to determine if 25 first-year audiology students from an audiology program in a large Australian university felt their interactions with SPs and CBSs had improved their ability to interact with clients and perform a basic audiometric assessment. These students reported their interactions with the SPs significantly (p < .01) improved their performance in 10 out of 10 areas of client interaction and their interactions with the CBS significantly (p < .01) improved their abilities in 6 out of 8 areas of basic audiometry. They also reported that the SPs' portrayals of the cases and the content of the simulated cases were realistic, although further preparation for interacting with the SPs was desirable. Overall, these results support the continued investigation of SPs and CBSs as potential methods of training and assessing Australian audiology students in the areas of client interaction and basic audiometry.

Professional orchestral musicians are at risk of exposure to excessive noise when at work. This is an industry-wide problem that threatens not only the hearing of orchestral musicians but also the way orchestras operate. The research described in this paper recorded noise levels within a professional orchestra over three years in order to provide greater insight to the orchestral noise environment; to guide future research into orchestral noise management and hearing conservation strategies; and to provide a basis for the future education of musicians and their managers. Every rehearsal, performance, and recording from May 2004 to May 2007 was monitored, with the woodwind, brass, and percussion sections monitored in greatest detail. The study recorded dBALEQ and dBC peak data, which are presented in graphical form with accompanying summarized data tables. The findings indicate that the principal trumpet, first and third horns, and principal trombone are at greatest risk of exposure to excessive sustained noise levels and that the percussion and timpani are at greatest risk of exposure to excessive peak noise levels. However, the findings also strongly support the notion that the true nature of orchestral noise is a great deal more complex than this simple statement would imply.

Until greater consensus is reached, any diagnosis of (C)APD should be qualified by an explicit statement of the criteria used. Calls to abandon the use of (C)APD as a global label should also be supported.

This study demonstrates the practical importance of, and explains how to minimize potential artefacts due to, 4 inter-related issues relevant to AEP WT MRA, namely shift variance, phase distortion, reconstruction smoothness, and boundary artefacts.

The chirp-evoked ABR has been regarded as a more synchronous response than the click-evoked ABR, referring to the belief that the chirp stimulates lower-, mid-, and higher-frequency regions of the cochlea simultaneously. In this study a variety of tools were used to analyze the synchronicity of ABRs evoked by chirp-and click-stimuli at 40 dB HL in 32 normal hearing subjects aged 18 to 55 years ͑mean= 24.8 years, SD= 7.1 years͒. Compared to the click-evoked ABRs, the chirp-evoked ABRs showed larger wave V amplitudes, but an absence of earlier waves in the grand averages, larger wave V latency variance, smaller FFT magnitudes at the higher component frequencies, and larger phase variance at the higher component frequencies. These results strongly suggest that the chirp-evoked ABRs exhibited less synchrony than the click-evoked ABRs in this study. It is proposed that the temporal compensation offered by chirp stimuli is sufficient to increase neural recruitment ͑as measured by wave V amplitude͒, but that destructive phase interactions still exist along the cochlea partition, particularly in the low frequency portions of the cochlea where more latency jitter is expected. The clinical implications of these findings are discussed.