![]() ![]() Next, we review the literature on various behavioral and electrophysiologic tests that exhibit some sensitivity to age-related central auditory processing declines. ![]() We first provide a brief contrast between our current understanding of auditory processing and how that differs from cognitive processing. The purpose of this article is to provide an overview of assessment and rehabilitative approaches for central auditory processing deficits in older adults. In contrast, when an older adult exhibits listening-related issues that are poorer than expected for age, hearing sensitivity, and physical and mental health, one cannot help but wonder if the central auditory system is affected. 2 When interventions such as hearing aids or auditory training demonstrate positive outcomes in older adults, it is not always apparent what mechanisms facilitated the change. What is less clear, however, is whether there is an isolated or pure form of central auditory processing decline in older adults (sometimes referred to as “central presbycusis”). 1 2 In general, many would agree that older adults are susceptible to a variety of age-related auditory declines, including changes in hearing sensitivity and changes in higher-order cognitive processes. The notion that a central auditory processing deficit (or disorder) is possible in older adults is not a novel one and is quite complex, often with many more questions than there are answers. The management of auditory processing disorders can be categorized in three areas: modification of the listening environment, often with the use of assistive listening technology direct treatment for the disorder and development of compensatory strategies and techniques.Learning Outcomes: As a result of this activity, the participant will be able to (1) describe at least three behavioral and electrophysiologic manifestations of age-related central auditory processing deficit, and (2) list at least three common behavioral tests that may be used to assess central auditory processing in older adults. Recommendations are generated from the assessment that helps to link the diagnosis to treatment and management. The assessment takes about 2 hours and provides insight into the types of auditory processing deficits present and the impact of these deficits on academics or the work environment. ![]() The assessment is designed to “tax” the auditory system in order to make it work under less than optimal conditions and to determine the ability of the auditory system to be flexible under these conditions. ![]() Case history information provided by referral sources, school, and family all contribute to the assessment. The auditory processing assessment is done to determine if an auditory processing disorder is present, and if so, to determine the parameters of the disorder in order to guide management. Normal cognitive functioning should be established prior to seeking an auditory processing assessment. In addition, children that have been identified as being on the autism spectrum are not appropriate for this type of testing. Prior to testing, peripheral hearing loss should be ruled out. In children, testing is most effective at age 7 or older. It is a low-incidence diagnosis and other types of causes for the suspected auditory difficulties should be ruled out prior to implementing an auditory processing evaluation. The diagnosis of auditory processing disorder is under the scope of practice of the profession of audiology. related to a head injury or illness), or a “wiring” issue thought to have a genetic component.Īuditory processing disorders are assessed by audiologists as part of an interdisciplinary team approach. Auditory processing disorders can be the result of a developmental delay, a disorder of the central auditory nervous system (e.g. These types of problems may result in the listener struggling to hear in less than optimal situations, not being able to understand non-native speakers of their language, and struggling with people who speak rapidly, among other deficits. People with auditory processing disorders may have deficits in processing of auditory information in a number of ways: they may have difficulty listening when background noise is present, difficulty with “filling in” missing auditory information, problems with combining information between the two ears (called dichotic listening), and issues with the timing of auditory information, just to provide a few examples. Simply put, these are disorders in which the person appears as if they have a peripheral hearing loss but have normal hearing on the audiogram, or pure tone test. Auditory processing disorders (APD) can be observed in both children and adults. ![]()
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