Use of Questionnaire-Based Measures in the Assessment of Listening Difficulties in School-Aged Children

Abstract

Objectives: In this study, the authors assessed the potential utility of a recently developed questionnaire (Evaluation of Children's Listening and Processing Skills [ECLiPS]) for supporting the clinical assessment of children referred for auditory processing disorder (APD).

Design: A total of 49 children (35 referred for APD assessment and 14 from mainstream schools) were assessed for auditory processing (AP) abilities, cognitive abilities, and symptoms of listening difficulty. Four questionnaires were used to capture the symptoms of listening difficulty from the perspective of parents (ECLiPS and Fisher's auditory problem checklist), teachers (Teacher's Evaluation of Auditory Performance), and children, that is, self-report (Listening Inventory for Education). Correlation analyses tested for convergence between the questionnaires and both cognitive and AP measures. Discriminant analyses were performed to determine the best combination of tests for discriminating between typically developing children and children referred for APD.

Results: All questionnaires were sensitive to the presence of difficulty, that is, children referred for assessment had significantly more symptoms of listening difficulty than typically developing children. There was, however, no evidence of more listening difficulty in children meeting the diagnostic criteria for APD. Some AP tests were significantly correlated with ECLiPS factors measuring related abilities providing evidence for construct validity. All questionnaires correlated to a greater or lesser extent with the cognitive measures in the study. Discriminant analysis suggested that the best discrimination between groups was achieved using a combination of ECLiPS factors, together with nonverbal Intelligence Quotient (cognitive) and AP measures (i.e., dichotic digits test and frequency pattern test).

Conclusions: The ECLiPS was particularly sensitive to cognitive difficulties, an important aspect of many children referred for APD, as well as correlating with some AP measures. It can potentially support the preliminary assessment of children referred for APD.

Fig. 1.

Box plot summary of performance on the different clinical auditory processing (AP) tests for the subgroups (typically developing [TD]; AP−; AP+). The boxes encompass the interquartile range of performance, with median performance indicated by the thick line. The whiskers show the range of performance, with outliers (o) defined as points more than 1.5 box lengths away from the upper or lower edge. DDT indicates dichotic digits test; FPT, frequency pattern test; GIN, gaps-in-noise; LiSN-S, listening in spatialized noise; MLD, masking level difference.

Fig. 2.

Correlations between the Evaluation of Children’s Listening and Processing Skills (ECLiPS(total)) (standard score [SS] x axes)) and Listening Inventory for Education (LIFE), Teacher’s Evaluation of Auditory Performance (TEAP), and Fisher’s auditory problem checklist (FAPC) (raw scores, y axes) for the typically developing (TD) (▴) and clinical groups (▫). Fit lines are provided for each group separately (dashed/dotted lines) as well as for all participants (solid line).

Fig. 3.

Plot of standard scores (SS) for the Evaluation of Children’s Listening and Processing Skills Language/Literacy/Laterality (L/L/L) factor against z scores for mean performance on the dichotic digits test. TD indicates typically developing.

Fig. 4.

Plot of Evaluation of Children’s Listening and Processing Skills (Language/Literacy/Laterality [L/L/L]) (standard score [SS]) against z scores for the Wheldall Assessment of Reading Passages (WARP) (A), attention (B), digit span backward (C), and nonverbal intelligence (NVIQ) (D). TD indicates typically developing.

Fig. 5.

Final discriminant analysis showing how the two extracted functions separated the groups. Function 1, predominantly reflecting contributions from Evaluation of Children’s Listening and Processing Skills (ECLiPS) (Language/Literacy/Laterality [L/L/L] and Memory & Attention [M&A]) and Teacher’s Evaluation of Auditory Performance (TEAP), separated the typically developing (TD) from the clinical groups. Function 2, predominantly reflecting the contributions from dichotic digits test (DDT), frequency pattern test (FPT), nonverbal intelligence (NVIQ), and M&A, separated the AP− from the AP+ and TD groups. AP indicates auditory processing.