CANADIAN GUIDELINES ON AUDITORY PROCESSING DISORDER IN CHILDREN AND ADULTS: ASSESSMENT AND INTERVENTION December 2012 Canadian Association of Speech-Language Pathologists and Audiologists www.cisg-gdci.ca [email protected] Table of Contents Table of Contents ................................................................................................................... 2 Disclaimer .............................................................................................................................. 4 Interorganizational Steering Group for Speech Language Pathology and Audiology ................ 4 Update and review ................................................................................................................. 4 Changes to web links .............................................................................................................. 4 Author sub-committee ........................................................................................................... 4 Acknowledgements ................................................................................................................ 4 Executive Summary ................................................................................................................ 5 CHAPTER 1 .............................................................................................................................. 6 INTRODUCTION AND FRAMEWORK .................................................................................................. 6 1.1. Introduction ............................................................................................................................. 6 1.2. Moving to a 21st century perspective ..................................................................................... 6 1.3. Working within a theoretical framework for the Canadian context ........................................ 7 1.4. Guideline consumers ............................................................................................................... 8 CHAPTER 2 ............................................................................................................................ 10 GUIDING PRINCIPLES, DEFINITIONS AND COMPETENCIES ............................................................... 10 2.1. The International Classification of Functioning, Disability and Health .................................. 10 2.2. Body functions and structures ............................................................................................... 10 2.3. Activity and participation ....................................................................................................... 11 2.4. Contextual factors .................................................................................................................. 11 2.4.1. Environmental factors ...................................................................................................................... 11 2.4.2. Personal factors ............................................................................................................................... 11 2.5. Professionals involved in assessment and management of auditory processing disorder .... 13 2.6. Definition of auditory processing disorder ............................................................................ 13 2.7. Prevalence of auditory processing disorder ........................................................................... 14 2.8. Clinical competencies ............................................................................................................ 15 2.8.1. Clinical knowledge base ................................................................................................................... 15 2.8.2. Knowledge of community resources ............................................................................................... 16 CHAPTER 3 ............................................................................................................................ 17 ASSESSMENT AND MANAGEMENT OF CHILDREN WITH AUDITORY PROCESSING DISORDER ........... 17 3.1. Indications for referral ........................................................................................................... 17 3.2. Personal factors ..................................................................................................................... 18 3.2.1. Age ................................................................................................................................................... 18 3.2.2. Cognitive, developmental, personality and learning disorders ....................................................... 18 3.2.3. Peripheral hearing loss ..................................................................................................................... 19 3.3. Screening ............................................................................................................................... 20 3.4. Assessment of auditory capacities ......................................................................................... 20 3.5. Pre-assessment information gathering and case history ....................................................... 21 3.6. Tools for assessment of auditory capacity ............................................................................. 21 3.7. Interpretation of auditory capacity test assessment ............................................................. 23 3.7.1. Delay vs. disorder ............................................................................................................................. 25 3.7.2. Re-evaluation ................................................................................................................................... 25 3.8. Intervention to improve participation ................................................................................... 25 3.9. Environmental factors to improve participation .................................................................... 27 3.9.1. Physical environmental factors ........................................................................................................ 27 Canadian Guidelines on Auditory Processing Disorder in Children and Adults: Assessment and Intervention 2 3.9.2. Partnership with the classroom teacher and school staff ............................................................... 27 3.9.3. Acoustics of the environment .......................................................................................................... 28 3.9.4. Assistive listening devices ................................................................................................................ 28 3.9.5. Social environmental factors ........................................................................................................... 30 3.9.6. Support, relationships and attitudes ............................................................................................... 30 3.9.7. Services, systems and policies ......................................................................................................... 30 3.10. Personal factors to improve participation ......................................................................... 31 3.10.1. Improving auditory capacities by direct intervention ...................................................................... 31 3.10.2. Improving the child’s ability to be active in communication and learning ...................................... 32 CHAPTER 4 ............................................................................................................................ 34 ASSESSMENT AND MANAGEMENT OF AUDITORY PROCESSING DISORDER ..................................... 34 IN ADULTS ...................................................................................................................................... 34 4.1. Introduction ........................................................................................................................... 34 4.2. Indications for referral ........................................................................................................... 35 4.3. Personal factors ..................................................................................................................... 35 4.3.1. Age ................................................................................................................................................... 35 4.3.2. Cognition .......................................................................................................................................... 36 4.3.3. Tumours ........................................................................................................................................... 37 4.3.4. Cerebrovascular disorders or stroke ................................................................................................ 38 4.3.5. Traumatic brain injury ...................................................................................................................... 38 4.3.6. Epilepsy ............................................................................................................................................ 39 4.3.7. Solvent exposure .............................................................................................................................. 40 4.3.8. Demyelinating disorders and neurodegenerative diseases ............................................................